bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late‐onset neurofibromatosis in a liver transplant recipient
Authors: Miller Martin B. ,   md, Tonsgard James H. ,   md, Soltani Keyoumars ,   md
Published: March 2003

A 44‐year‐old Caucasian man was admitted in December 1995 for the treatment of generalized skin pruritus. The patient had a history of cirrhosis felt to be caused by chronic ethanol abuse and renal insufficiency. He had undergone orthotopic liver transplantation in January 1991. Physical examination revealed numerous, fleshy, nontender nodules protruding from the face ( Fig. 1), trunk, and extremities, as well as axillary freckling. The patient was certain that the lesions had appeared 2–‐3 months after his liver transplant. Wood's lamp examination revealed several café‐au‐lait macules. Ophthalmic examination was remarkable for Lisch nodules (
Fig. 2).A representative clinical lesion as a fleshy, non‐tender nodule on the neck. Also a few very small lesions are barely visible on the mandible lineimageIris hamartomas (Lisch nodules) in our patientimageTwo skin nodules on contralateral sides of the body were biopsied. Histologic examination of the nodules revealed a normal epidermis and a nonencapsulated dermal mass composed of thin, wavy eosinophilic fibers lying in loosely textured strands. Interdispersed among these strands were cells with spindle‐shaped or oval nuclei and an increased number of mast cells. The histology was typical of a neurofibroma ( Fig. 3).Histopathologic features of a cutaneous nodule demonstrating normal epidermis overlying a non‐encapsulated dermal mass (left panel), with loosely‐textured thin wavy eosinophilic fibers and strands, containing cells with spindle‐shaped or oval nuclei (right panel)imageComputed tomography (CT) scans of the chest, abdomen, and pelvis taken before and after the transplant surgery did not reveal any internal plexiform neurofibromas.A thorough review of the patient's medical record dating to shortly after birth made no mention of any skin nodules or hyperpigmentation prior to the transplant. There was no family history of neurofibromatosis.The patient's pruritus resolved with UVB light therapy and hemodialysis. Currently, the patient is on hemodialysis with no clinical progression of his neurofibromatosis.
Tinea capitis in Benghazi, Libya
Authors: Gargoom Ali Mohamed , Elyazachi Moayed B. , Al‐Ani Sabah Maki , Duweb Gamal Ahmed 
Published: March 2003

Abstract Background Tinea capitis is a worldwide problem. It affects mainly school age children. Late detection and improper treatment of the inflammatory type of this disease may result in disfigurement and permanent alopecia. The objectives of this study were to determine the prevalence, clinical types, and causative species of tinea capitis in Benghazi, Libya. Methods One hundred and ninety six patients with tinea capitis were enrolled in this study. Hair stumps and scales were collected from every case and exposed to direct microscopic examination using 10% potassium hydroxide solution, and cultivation on modified Sabouraud's dextrose agar with cyclohexamide and chloramphenicol. Results Tinea capitis accounts for 45% of all superficial fungal infection and 92% occurred in children below the age of 10 years. The gray patch type was the most common clinical variety (53.6%), followed by black dots, seborrhoid type, and kerion (25.5%, 10.2%, and 8.2%), respectively. Four patients with a clinical picture of alopecia areata‐like lesion and one patient with a favus‐type lesion were seen. Species identification revealed that Trichophyton violaceum was the most common causative agent, responsible for 49.4% of infection, followed by Microsporum canis (38.6%) and T. verrucosum (7.8%). From seven patients the isolate was a mixture of both T. violaceum and M. canis. Conclusions There has been a dramatic decrease in the incidence of favus with complete disappearance of T. schoenleinii. T. verrucosum as a causative agent of tinea capitis in this area has been reported for the first time in this study.
Treatment of scalp seborrheic dermatitis and psoriasis with an ointment of 40% urea and 1% bifonazole
Authors: Shemer Avner , Nathansohn Nir , Kaplan Baruch , Weiss Glen , Newman Nathan , Trau Henri 
Published: March 2003

Seventy‐one patients (52 patients with psoriasis capitis and 19 with scalp seborrheic dermatitis) enrolled in this open‐label study. All had stable disease for at least 6 months. Patients who were allergic to imidazoles, were pregnant or breastfeeding, or were aged less than 18 years were excluded. Only psoriatic patients with scalp involvement alone or whose body surface area involvement was less than 25% were included. All patients reported incomplete response to previous topical therapies (used alone or in combination: corticosteroids, salicylic acid, tar, anthralin, and ketoconazole shampoo) and had a washout period of at least 1 month.The patients applied 40% urea plus 1% bifonazole in an ointment base nightly. They were instructed to apply a fixed amount (1 cm in length = 0.32 g) of ointment for each 10 cm 2of involved area. Each morning, 1% bifonazole shampoo was applied for 5 min and rinsed with water; 10–20 min later, one drop of 1% bifonazole solution per 10 cm
2area was applied to the scalp. This treatment regimen was repeated daily for 7 days. If clearance was not achieved in the first week, the regimen was continued for one more week.After this initial treatment (for 7 or 14 days), maintenance therapy with once‐weekly application of the regimen was continued for up to 3 months. In addition, during this follow‐up period, the scalp was washed in 2‐day intervals with the shampoo alone, which was left on for 5 min and then washed off.On each visit (weeks 0, 1, 2 and 12), the scalp was evaluated for redness, scaling, and pruritus and each parameter was scored as absent (0), mild 1, moderate
2, or severe
3. On each visit, the scalp's condition was scored as follows: worsening (− 1), no improvement (0), mild (0–25%) improvement
1, moderate (25–50%) improvement
2, marked (50–75%) improvement
3, and (> 75%) cleared
4.
The therapeutic potential of calcipotriol in diseases other than psoriasis
Authors: Holm Elisabeth A. , Jemec Gregor B. E. 
Published: March 2003

AbstractBackground Calcipotriol is a vitamin D analog, which has antiproliferative and anti‐ inflammatory effects, and stimulates terminal differentiation. It has been an established treatment for psoriasis since 1991 in Europe and 1994 in the USA.Objective To assess the clinical efficacy of topical calcipotriol in diseases other than psoriasis.Results A total of 36 original papers were found describing 21 different diseases in which the clinical use of calcipotriol ointment was described as having an effect. These papers were predominantly case reports (n = 22) and observational studies (n = 5), but nine papers described small randomized controlled trials.Conclusions Calcipotriol may generally be effective in diseases characterized by pathogenic elements, such as impaired differentiation or increased keratinocyte proliferation, and activated T lymphocytes. This study of the existing literature suggests that randomized, double‐blind, placebo‐controlled studies of calcipotriol therapy may be worthwhile in a number of diseases.
Acute febrile neutrophilic dermatosis (Sweet’s syndrome) with nodular episcleritis and polyneuropathy
Authors: Kato Taizo , Kunikata Nagisa , Taira Hikaru , Kobayashi Naoki , Tanji Kazuyo , Endo Minoru 
Published: March 2003

A 56‐year‐old Japanese housewife presented with multiple erythematous lesions in association with ocular hyperemia and pain in the right upper and lower extremities, including the hands and feet. These symptoms were preceded by a sore throat with persistent fever higher than 38.5 °C for about 1 week.Dermatologic examination showed tender, dull‐red, erythematous lesions, measuring 1–2 cm in diameter, located predominantly on the forehead, cheeks, auricular region, neck, forearm, hands, and feet. A biopsy specimen obtained from an erythematous lesion on the right forearm revealed prominent edema in the papillary dermis and remarkable inflammatory cell infiltration throughout the entire dermis (Fig. 1). The infiltrate predominantly consisted of neutrophils and nuclear dust without signs of vasculitis. In routine examination, the leukocyte count was 15,000/mL (normal range, 4000–8000/mL) with severe neutrophilia (80%). The C‐reactive protein (CRP) level was 17.65 mg/dL (normal range, < 0.5 mg/dL) and the anti‐streptolysin (ASLO) level was 611 IU/mL (normal range, < 166 IU/mL). In human leukocyte antigen (HLA) testing, HLA‐A2, ‐B39, ‐B35, ‐Cw2, and ‐Cw7 were positive, and HLA‐B51, ‐B54, and ‐Cw1 were negative.Histologic picture showing a dermal infiltrate of neutrophilsimageOcular hyperemia was caused by episcleritis forming a nodule and surrounding congestion of the superficial episcleritic vessels at the central portion of the sclera (Fig. 2). The patient suffered from pain once an hour, continuing for about 3 min, at the lateral portion of the right upper and lower extremities, as well as the right small finger. Neurologic examination demonstrated moderate or slight muscle weakness in the extremities. Hand grasping powers were 9 and 7 kg on the right and left, respectively. The patient was right‐handed. Dysesthesia and paresthesia were also observed on the hands and feet. The deep tendon reflexes were preserved, however, even in the distal portion of the upper and lower limbs. In addition, essential tremor localized to the neck was recognized. Magnetic resonance imaging did not show any episodes of transient abnormal signal intensity in the central nervous system.Nodular episcleritis (right eye). Telangiectasia of winding vessels with nodular elevation was observed at the upper portion of the scleraimageThe patient was treated with prednisolone (initial dose of 30 mg/day) and intravenous injection of cefazolin sodium (2 g/day for 5 days). Almost complete regression of the ocular and neurologic manifestations, as well as the skin lesions, was achieved in 2 weeks. Prednisolone was reduced gradually and suspended after 4 weeks. Leukocyte and neutrophil counts, CRP, and ASO returned to normal on suspension of therapy. Slight paresthesia remained in the right small finger even after stopping steroid. There was no recurrence at follow‐up 6 months later.
Immunoablative high‐dose cyclophosphamide without stem cell rescue in pemphigus foliaceus
Authors: Cohen Mark A. , Cohen Jonathan J. , Kerdel Francisco A. 
Published: March 2003

AbstractBackground  There is growing evidence that immunoablative high‐dose cyclophosphamide without stem cell rescue is effective and safe in patients with refractory autoimmune diseases such as paraneoplastic pemphigus, systemic lupus erythematosus, aplastic anemia, and more recently pemphigus vulgaris.Methods  We report a 51‐year‐old patient with severe pemphigus foliaceus, which was recalcitrant to multiple medical regimes. The patient presented with multiple thick hyperpigmented and scaly, ill‐defined plaques on the face. In addition, she had multiple superficial erosions and crusts on her scalp, thorax, upper and lower extremities. The patient also had a few discrete intact flaccid bullae. A skin biopsy and direct immunofluorescence was consistent with pemphigus foliaceus. The patient's circulating pemphigus autoantibodies were present at a titer of 1 : 2560. The patient received immunoablative high‐dose cyclophosphamide (50 mg/kg/day) for 4 consecutive days, and tolerated the regime well.Results  Approximately 3 months after therapy, the skin lesions had healed and her prednisone, which had been as high as 80 mg daily, was tapered to 30 mg daily. In addition, her circulating autoantibodies decreased after treatment. Nearly 10 months after treatment, the patient did relapse. However, her disease was less severe and more easily managed with lower doses of immunosuppressive therapy.Conclusion  This case contributes to the growing evidence of high‐dose cyclophosphamide's efficacy without stem cell rescue in recalcitrant autoimmune diseases, including pemphigus foliaceus.
Malignant melanoma mortality rates in Chile (1988–98)
Authors: Zemelman Vivian , Garmendia M. L. , Kirschbaum A. 
Published: March 2003

AbstractBackground Malignant melanoma (MM) mortality has increased in the Caucasian population many fold over the past several decades. In this study, we analyzed the Chilean‐specific, age‐adjusted MM mortality rates per 100,000 population during the decade 1988–98 in order to establish changes in that period.Methods We analyzed all death certificates from the Chilean Death Registry Office (1988–98) and retrieved the deaths attributed to MM. The data were categorized according to sex and age group. The annual age‐adjusted and sex‐specific rates of MM mortality per 100,000 population were calculated.Results Chilean MM mortality rates increased by 14% between 1988 and 1998. The relative risk for males vs. females was 1.3 with a tendency to rise, showing an increase of 30%. The relative risk of dying from MM in Chile increased linearly with age. An individual of 75 years or older had a 44.24 times greater risk of dying of MM than an individual in the 0–44‐year age group. The rates in the > 75‐year age group also showed a tendency to rise over the decade, with an increase of 64% (1988–98).Conclusions The Chilean MM mortality rates are lower than the world standardized rates. The total Chilean MM mortality rates showed an increase over the decade 1988–98, mainly due to MM mortality in males. The MM mortality in Chilean females was lower than that in males, and was unchanged over the decade; this is in agreement with the results reported in other countries. This is one of the first studies of MM mortality in the Chilean population. The results are important when the geographic location of Chile is considered.
Perception of men with androgenetic alopecia by women and nonbalding men in Korea: how the nonbald regard the bald
Authors: Lee Hyun‐Jeong , Ha Seog‐Jun , Kim Dongjae , Kim Hyung‐Ok , Kim Jin‐Wou 
Published: March 2003

AbstractBackground Baldness has significant negative psychosocial effects. It has been asserted that the negative effects of baldness are often trivialized by the nonbald. Most studies concerning the perception of baldness have focused on the perceptions of the bald by themselves. In this study, we assessed the perception of baldness by the nonbald in Korea.Method A questionnaire on the perception of balding men was answered by 130 women (age range 15–58 years), 90 nonbalding men (age range 18–72 years) and 30 balding men (age range 20–63 years).Results Balding men were perceived as being older and less attractive by over 90% of respondents. A perception that balding men are less confident, duller, and less potent was reported by less than half of respondents. A perception that balding men are less attractive was significantly more common among women than among nonbalding men (P < 0.05). A perception that balding men appear less confident was significantly more common among balding men than among nonbalding men (P < 0.05).Conclusion In this study of Koreans, the perception of balding men by others was similar to the perception of balding men by themselves. It is likely that androgenetic alopecia adversely influences social interactions of those who are subject to it.
Milia en plaque in a renal transplant patient: a rare presentation
Authors: Dogra Sunil , Kaur Inderjeet , Handa Sanjeev 
Published: March 2003

A 56‐year‐old man presented with a 1‐month history of an asymptomatic, erythematous plaque studded with numerous white elevated lesions over the right lower limb. He denied a history of trauma, any topical applications, or ionizing radiation to that area. For the past 2 years following renal transplantation, the patient had taken immunosuppressive therapies. His current medications included cyclosporine, 100 mg, azathioprine, 100 mg, and prednisolone, 7.5 mg, daily. Cutaneous examination revealed an indurated, erythematous, 6 × 4 cm, well‐marginated plaque with overlying, numerous, tiny, yellowish papules present over the lower one‐third of the anteromedial aspect of the right leg (Fig. 1). The patient also had a few discrete milia on the right cheek. There was no tenderness or local warmth. The patient had no systemic symptoms. Histopathology of the skin lesions could not be performed as the patient refused skin biopsy.Patient's hands showing prominent acral cyanosis and bluish discolorationimage
Autoimmune and rheumatic manifestations and antinuclear antibody study in HIV‐infected Thai patients
Authors: Kulthanan Kanokvalai , Jiamton Sukhum , Omcharoen Viboon , Linpiyawan Rumpa , Ruangpeerakul Jaratsak , Sivayathorn Apichati 
Published: March 2003

AbstractBackground There have been reports concerning an association between human immunodeficiency virus (HIV) infection and autoimmune and rheumatic diseases.Objective The purpose of this study was to examine autoimmune and rheumatic manifestations in HIV‐infected patients and their correlation with antinuclear antibody (ANA) tests.Methods The clinical and laboratory results of HIV‐infected patients attending the Department of Dermatology, Siriraj Hospital, Bangkok, Thailand, from February 1999 to January 2000, were analyzed. Laboratory studies included serum CD4 lymphocyte count and ANA tests.Results Sixty‐two patients were enrolled prospectively in the study. Myalgia was the most common clinical presentation (50%). Others included photosensitivity (on history) (39%), arthralgia (26%), vasculitis (18%), sicca complex (10%), arthritis (7%), and Reiter's syndrome (2%). A history of hair loss was given by 23% of patients. A positive ANA test was detected in 3%. No cases of systemic lupus erythematosus, scleroderma, or dermatomyositis were seen.Conclusions Autoimmune and rheumatic manifestations were not uncommonly detected in patients with HIV infection. HIV infection may sometimes mimic systemic lupus erythematosus clinically.
Metastatic gastric cancer presenting as a solitary axillary cutaneous nodule
Authors: Sáez‐Rodríguez Miguel , García‐Bustínduy Marta , Noda‐Cabrera Antonio , Guimerá‐Martín‐Neda Francisco , Dorta‐Alom Sara , Escoda‐García Marina , Fagundo‐González Eva , Sánchez‐González Rosalba , Sanz‐Manzano Cipriano , Martín‐Herrera Antonio , García‐Montelongo Rafael 
Published: March 2003

An 84‐year‐old man, with a medical history of dilated cardiomyopathy, was admitted to our hospital with a nodular lesion in his right axilla of 6 weeks’ duration. There was no history of weight loss, nausea, or vomiting. Physical examination revealed a red–violet axillary nodule, 7 cm in diameter and 3 cm thick, with an ulcerated surface (Fig. 1). A palpable right adenopathy was also found. The rest of the physical examination was normal.Cutaneous nodule located on the right axillaimageA metastatic tumor from an unknown origin was suspected. A biopsy of the cutaneous nodule was performed.Hematoxylin and eosin staining revealed a round and well‐defined nodule, located in the dermis. The nodule was composed of solid nests of atypical cells, with large nuclei and scanty cytoplasm, which tended to form a pseudoglandular pattern (Fig. 2). Atypical mitotic figures were frequently seen. Immunohistochemical examination of the tumoral cells showed a positive reaction with carcinoembryonic antigen and cytokeratin KL1 and a negative reaction with antileukocyte antibody.Tumoral cells with pseudoglandular pattern (hematoxylin and eosin stain, ×40)imageWith these histologic findings, a diagnosis of cutaneous metastasis was made. Blood laboratory evaluation revealed an elevated erythrocyte sedimentation rate (43 mm/h). Tumor markers, including α‐fetoprotein, carcinoembryonic antigen, prostate‐specific antigen, squamous cell carcinoma antigen, and carbohydrate antigen 19–9, were all within normal limits. A chest X‐ray film was normal and an occult blood test was also negative.Neck and chest computed tomography scan identified some adenopathies located on the neck and the right axilla. Barium studies showed an intramural mass lesion in the minor curvature of the stomach. An upper gastrointestinal tract endoscopy showed a submucosal nodule in the cardia. Biopsy of this gastric nodule demonstrated a poorly differentiated carcinoma. Biopsy of both cervical and axillar lymph nodes was performed and no tumoral cells were found.Abdominal–pelvic computed tomography scan and bone scintigraphy showed no pathologic findings. Although supportive chemotherapy was performed, the patient died 6 months later.
Leser‐Trelat sign
Authors: Ceylan Can , Alper Sibel , Kılınç Işıl 
Published: March 2003

A male patient aged 74, an inpatient at the chest diseases clinic at Ege University Hospital, ⋖zmir, Turkey with squamous cell carcinoma in the right lung, was referred for consultation to the dermatology outpatient clinic as he presented with itchy papules recently increasing in number and a lesion on his nose with a duration of 2 years. In a lung X‐ray taken to investigate hemoptisis, a mass 7 × 5 cm in size was observed on the upper part of the right lung, and as a result of lung biopsy, squamous cell carcinoma (T41MO‐phase 3b) was diagnosed. The patient had been smoking 10 cigarettes a day for 60 years and had been taking digoxin for heart insufficiency for 7 years. Biochemical laboratory analyses of the case were observed to be within normal limits and no findings of metastasis were obtained in ultrasonographic and tomographic scanning.In the dermatological examination, an ulceration on the apex nasi, 2 × 1.5 cm in size, covered with crusts, was observed. On the thorax, lesions parallel to one another, linearly distributed, partly pigmented and raised from the skin, having a diameter of 0.5–2 cm, were observed, consistent with seborrheic keratoses (Fig. 1). In addition to these lesions, symmetrically localized, velvety, slightly raised plaques with light brown pigmentation were present on the axillary folds (Fig. 2).Seborrheic keratosis lesions on the backimageAcanthosis nigricans plaque on the axillary foldimageHistopathological investigation of the incisional biopsy taken from the apex nasi revealed tumor islands of different sizes. Histopathological changes were found to be in accordance with solid‐type basal cell carcinoma. In the histopathological investigation of the incisional biopsy taken from the lesion consistent with seborrheic keratosis, epidermal thickening consisting of basaloid cells and keratin cysts was observed, and the result of the biopsy taken from the axilla was acanthosis nigricans, showing hyperkeratosis, focal acanthosis and papillomatosis in the epidermis.
Polymerase chain reaction in cutaneous tuberculosis: is it a reliable diagnostic method in paraffin‐embedded tissues?
Authors: Senturk Nilgün , Sahin Sedef , Kocagoz Tanil 
Published: March 2003

AbstractBackground Most cutaneous tuberculosis lesions contain few bacilli, so identification of Mycobacterium tuberculosis in conventional laboratory tests is difficult. In vitro amplification of specific DNA sequences using polymerase chain reaction (PCR) has become a valuable tool in the rapid detection of slow‐growing organisms like M. tuberculosis.Aim To investigate the presence of M. tuberculosis DNA in cutaneous tuberculosis.Methods Twenty‐two archival biopsy specimens diagnosed as cutaneous tuberculosis were investigated for the presence of M. tuberculosis DNA by PCR. Normal skin samples of 29 healthy patients were used as a control.Results Amplification of the M. tuberculosis DNA was observed in one of the cutaneous tuberculosis specimens and in a healthy control.Conclusion Although PCR is a rapid diagnostic method, fixation procedures may decrease its sensitivity.