bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nailfold capillary abnormality and pulmonary hypertension in systemic sclerosis
Authors: Ohtsuka Tsutomu , Hasegawa Akira , Nakano Akihiko , Yamakage Akio , Yamaguchi Mary , Miyachi Yoshiki 
Published: November 2003

Abstract Background Patients with systemic sclerosis (SSC) show a capillary abnormality of nailfolds with controversial correlation with organ involvement. Our purpose was to study the correlation between this nailfold capillary abnormality and pulmonary hypertension in patients with SSC. Methods We studied the nailfold capillaries, using capillary microscopy, and the pulmonary arterial pressure, using right‐heart catheterlzation, in 44 patients with SSC. Canonical discriminant analysis was used to define the capillary abnormality in patients with SSC, which was then compared with that of 40 normal controls. The correlations between the patterns of nailfold capillaries and the cardiopulmonary findings. Including the pulmonary arterial pressure, were examined using Fisher's test. Results Thirty‐two of 44 patients with SSC could be differentiated from normal controls by our definition of the SSC pattern. The SSC pattern correlated significantly with elevated pulmonary vascular resistance, as well as with pulmonary fibrosis, eiectrocardiographic abnormalities, decreased vital capacity, and decreased diffusing capacity for carbon monoxide. All SSC patients with pulmonary hypertension showed this SSC pattern. In patients with elevated pulmonary arterial pressure, capillary microscopy and diffusion capacity for carbon monoxide (DCCM) showed the highest rate of abnormalities. A limited‐type SSC significantly correlated with DCCM and with anticentromere antibody, and the diffuse‐type SSC with pulmonary fibrosis and anti‐sci‐70 antibody. Conclusion Our data suggest that in patients with SSC, nailfold capillary abnormalities correlate with pulmonary arterial hypertension as well as with clinical and laboratory findings indicating pulmonary hypertension.
Toxic epidermal necrolysis – a retrospective study
Authors: Criton S. , Devi K. , Sridevi P.K. , Asokan P.U. 
Published: November 2003

Abstract Background Toxic epidermal necrolysis (TEN) is a severe, idiosyncratic, exfoliative disease of the skin and mucous membranes. The treatment of this condition is controversial. High‐dose corticosteroid therapy has been the most commonly advocated treatment, but, more recently, this has changed to a no‐steroid protocol. These conflicting treatments prompted us to evaluate retrospectively our protocol. Methods The patients admitted to the hospital from 1989 to 1995 with a clinical diagnosis of TEN were included in the study. These patients were given systemic steroids, prophylactic antibiotic, and supportive measures. Results The patients belonged to both sexes with an average age of 34 years. The average area of involvement was 85.62%. All the patients made an uneventful recovery without any evidence of sepsis. Conclusions Treatment with systemic steroids is useful in the management of TEN, and there is no need for a burn care center.
Complications of 585‐nm pulsed dye laser therapy
Authors: Boixeda Pablo , Núñez Mariía , Pérez Bibiana , de las Heras María Elena , Hilara Yolanda , Ledo Antonio 
Published: November 2003

Abstract Background Port‐wine stains (PWS) are a congenital, progressive ectasia of the superficial cutaneous vascular plexus that occur in 0.3%–0.5% of children at birth. They should be considered a disease with physical and psychologic complications. Treatment with the flashlamp pulsed dye laser (FPDL) has proven to be effective. Because treatment results in selective vascular injury, the risk of complications is minimal. The purpose of this study was to determine the cutaneous side‐effects and complications and their frequency in patients with PWS treated with the FPDL. Eighty‐nine patients who had been treated with the FPDL for PWS were included in this study. Methods Patients were treated at 3‐month intervals using slightly overlapping pulses with fluences of 6.0–9.0 J/cm2. Treating physicians were responsible for evaluating the patients. All patients were reviewed and side‐effects and complications were recorded. Results Pigmentary changes were the most frequently observed complications. Hyper‐and hypopigmentation appeared in 16.8% and 2.4% of patients, respectively. Cutaneous depressions occurred in 2.2% of patients. One patient developed a hypertrophic scar, and another patient presented with transient cutaneous pustulosis. All these changes usually resolved spontaneously and completely in a few months. Conclusions Most of the side‐effects and complications produced by the FPDL are usually transitory, and it is essentially a very secure technique.
The profile and outcome of pustular psoriasis in Singapore: a report of 28 cases
Authors: Tay Yong‐Kwang , Tham Siew‐Nee 
Published: November 2003

Abstract Background Pustular psoriasis is a rare form of psoriasis that can be divided into generalized and localized forms. The aim of this study is to describe the patient profile and outcome of pustular psoriasis seen at a tertiary referral skin center in a tropical country. Methods The records of all patients with pustular psoriasis during the 4 years from 1989 to 1993 were reviewed. Diagnostic criteria for selection included at least one episode of either generalized or localized macroscopic noninfective pustulation. Results There were 28 patients with pustular psoriasis, with an age range of 4–77 years. Nineteen patients had generalized pustular psoriasis: Von Zumbusch (seven), annular form (two), juvenile form (six), pustular psoriasis of pregnancy (one), and the localized form of generalized pustular psoriasis (three). Nine patients had localized pustular psoriasis: palmoplantar pustulosis (five) and acrodermatitis continua (four).Patients with the acute Von Zumbusch pattern had recalcitrant disease with multiple flares and significant morbidity and mortality. Patients with the annular form had a subacute onset and a chronic course. In patients with the juvenile form of generalized pustular psoriasis, two patterns could be recognized: Zumbusch form (four) and annular form (two). Despite significant morbidity, each of our young patients had a relatively benign course with no deaths and an excellent response to etretinate therapy. Our nine patients with localized pustular psoriasis all had a chronic course: the average duration of disease was 6 years for patients with palmoplantar pustulosis and 12 years for patients with acrodermatitis continua. ConclusionsThe pattern of pustular psoriasis seen in Singapore is similar to that reported in the Western literature. Using these categories we can provide guidelines for treatment and prognosis.
Coal tar therapy in paimoplantar psoriasis: old wine in an old bottle?
Authors: Kumar Bhushan , Kumar Ravi , Kaur Inderjeet 
Published: November 2003

Abstract Background Paimoplantar psoriasis (PPP) is a disabling condition which is usually resistant to most of the available therapeutic modalities. Coal tar is an accepted therapy for psoriasis which has not been well studied for PPP. Methods Thirty patients with a plaque type of PPP were allocated into two groups: Group A (19 patients) were treated with 6% crude coal tar (CCT) ointment and Group B (11 patients) were treated with white petrolatum and salicylic acid. In both groups, ointment was applied and left on overnight. Wearing of gloves and socks during the night and application of emollients in the day was routinely advised The lesions were assessed for erythema, scaling, and induration (ESI) every 2 weeks for a total of 8 weeks. Patients with greater than 50% improvement were considered to have good improvement. Side‐effects, if any, were also monitored. Results In Group A, 76.5% of patients (13/17) showed good improvement, whereas only 45.5% of patients (5/11) in Group B showed the same magnitude of improvement (P < 0.05). No side‐effects were reported by any patient in either of the groups. Conclusions Crude coal tar is a safe, effective, and inexpensive modality for the treatment of PPP. We recommend coal tar under occlusion, along with the liberal use of emollients, as the first line of therapy for all cases of PPP.
Khite: a non‐Western technique for temporary hair removal
Authors: Abdel‐Gawad Mamdouh M. , Abdel‐Hamid Ibrahim A. , Wagner Richard F. 
Published: November 2003

Abstract Background Khite (also known as fatlah in Egypt) is a manual technique of temporary vellus hair removal that is widely performed In the Middle East. Methods The technique of khite is reviewed as illustrated. Results Khite is an effective method of removing unwanted vellus hairs. Conclusions Dermatologists in all parts of the world should be familiar with khite, because the ease of international travel may bring patients to their attention who have khite‐association complications such as erythema, folliculitis, and secondary pigmentary changes.
Plasmapheresis in toxic epidermal necrolysis
Authors: Chaidemenos George Ch. , Chrysomallis Fotis , Sombolos Kostas , Mourellou Olga , Loannides Dimitris , Papakonstantinou Mary 
Published: November 2003

Abstract Background The treatment of toxic epidermal necrolysis (TEN) is usually based on the removal of the offending drug(s), fluid replacement, nutritional support, and local management. The mortality and morbidity, however, remain high and the death rate may be reduced to 10% only in special centers that use biologic dressings. Plasma exchange (PE) was proven efficacious in small series of patients and of no particular value in others. Methods Seven patients suffering from severe TEN covering 30%–80% of body surface area and having two or four mucous membranes involved, were included in this open study. Malignancy (Hodgkin's disease, brain tumor) and a variety of medicaments (carbamazepine, allopurinol, diphenylhydantoin, cefaclor, amoxicyllin with clavullanic acid) were considered as causally implicated. One to four PEs of 2.5 L were given on alternate days in six patients and on a daily basis in the seventh. Results All patients recovered successfully from their disease. No new lesions appeared after the first PE in four patients. Neither adverse reactions from this therapy nor sequelae from TEN were observed after a long follow‐up lasting up to 8 years. Conclusions Although PE is expensive and requires easy venous access to be performed, it could be listed in the first line of TEN therapy. The method is safe and efficacious, providing prompt relief from pain and rapid cessation of necrolysis. The alternate day PEs are considered preferable to the everyday regimen.
Topical calcipotriene in combination with UVB phototherapy for psoriasis
Authors: Hecker David , Lebwohl Mark 
Published: November 2003

A total of 20 patients with symmetric plaque‐type psoriasis were recruited for a controlled, investigator‐blinded, right–left study. None of the patients had used any therapy other than emollients for 2 months prior to starting in the trial. All patients had a negative antinuclear antibody. By history, all patients had previously improved upon exposure to sunlight or ultraviolet light. Two symmetrical sites of equal severity were selected as target areas. Each patient was treated on one side with mineral oil twice daily and on the opposite side with calcipotriene 0.005% ointment twice daily. The investigator was blinded as to which site received which topical treatment. Both sides were treated with equal doses of ultraviolet B (UVB) three times weekly in graduated suberythemogenic doses. Ultraviolet B radiation was emitted by a group of 6‐ft fluorescent bulbs (Light Sources FS72 T12 UVB HO) in a standard phototherapy unit.The above regimen was continued for a total of 12 weeks. The severity of psoriasis in the target sites was rated by the examiner at baseline and at weekly intervals for the 12 weeks of study. Target sites were rated by severity of erythema, scaling, plaque elevation, and pruritus, with each of these parameters being assigned a score on a four‐point scale: 0, clear; 1, mild; 2, moderate; 3, severe. The four scores were added together to arrive at a total severity score for each of the target sites.Statistical analysis was performed using the paired t test, P values less than 0.05 were considered statistically significant.Eleven of the 20 patients (55%) showed a greater decrease in the severity of their psoriasis with UVB plus calcipotriene compared with UVB plus mineral oil. The difference in severity scores between the two groups was statistically significant as early as week 1 (P < 0.05). The difference between the UVB and calcipotriene group versus the UVB and mineral oil group peaked between weeks 3 and 6. The differences then decreased but remained statistically significant through to week 12 (Fig. 1). There were no instances of local cutaneous irritation, but mild photosensitivity occurred symmetrically on both sides in three patients.
Demographic evaluation of successful antipsoriatic climatotherapy at the Dead Sea (Israel) DMZ Clinic
Authors: Harari Marco , Shani Jashovam 
Published: November 2003

Abstract Background Natural balneologic properties, thermomineral springs and unequivocal success in improving psoriasis, attract an ever‐growing number of psoriatlcs to the DMZ Clinic on the shores of the Dead Sea in Israel. MethodsThis paper analyses the rate of success of this balneotherapy in 740 psoriatics who flew in from Germany specifically for this treatment, during 1995, as a function of sex, family history of the disease, number of previous treatments at the Dead Sea, skin type, skin involvement, joint involvement, duration of treatment, sun‐exposure schedule, remission length, and psychologic supervision. ResultsAfter 4 weeks, 70% of the patients were completely cleared, this improvement being about the same across both sexes. Family history of the disease, skin type, and psychologic support did not affect the rate of success. On the other hand, previous treatments at the Dead Sea, moderate to severe skin surface involvement, and participation of arthritis, improved the chance of better clearing of the psoriatic condition. Similar improvement was obtained by a longer sun‐exposure schedule and a complete 4‐week treatment. Conclusion These results indicate that the medical improvement in the psoriatic condition after a 4‐week stay at the Dead Sea can be better enhanced and its remission prolonged if additional demographic and anamnestic factors are carefully taken into account.
Fluconazole in the treatment of tinea versicolor
Authors: Amer Mohamed A. ,   Egyptian Fluconazole Study Group
Published: November 2003

Patients with tinea versicolor (TV, n= 603) aged 18–65 years entered into an open, randomized, multicenter study to investigate the efficacy and toleration of three dosage regimens of fluconazole. The study was conducted in 10 different centers in six cities in Egypt.The patients were randomly assigned to one of three groups:Group I: received single 150 mg fluconazole capsule repeated weekly for 4 weeks;Group II: received two 150 mg capsules of fluconazole in a single dose repeated weekly for 4 weeks;Group III: received two 150 mg capsules of fluconazole in a single dose that could be repeated 2 weeks later.Five visits were scheduled for each group and the last follow‐up visit was always 28 days after the last fluconazole dose. Response to treatment was assessed clinically and by microscopic examination of KOH mounts of skin scrapings, weekly and 28 days after the last fluconazole dose. The number of fluconazole doses administered was guided by clinical and mycologic response, and the dose was repeated only if the patient showed residual clinical lesions or positive microscopy for skin scrapings.Final evaluation was rated as cure (disappearance of lesions with no or slight color changes), improvement (no scales while color changes were much less but still obvious), and failure (no or slight changes from baseline). Mycologic assessment was rated as eradication, persistence or relapse. All adverse events were recorded during the treatment period.
Testosterone concentrations and oligomenorrhea in women with acne
Authors: Hasinski Stefan , Telang Gladys H. , Rose Leslie I. , Pollock Jeffrey L. , Spielvogel Richard L. , Miller Jeffrey L. 
Published: November 2003

Abstract Background Androgen excess is frequently associated with oligomenorrhea as well as acne. Oligomenorrhea in hirsute women has been demonstrated to be associated with higher active testosterone levels than found in eumenorrheic hirsute women. This study was designed to evaluate whether similar findings are present in women with acne. Forty‐four consecutive women with acne were evaluated by measuring their levels of total testosterone, biologically active testosterone, and free testosterone. The women with oligomenorrhea and acne had significantly higher levels of biologically active testosterone than those with eumenorrhea and acne. This implies that biological active testosterone should be measured in oligomenorrheic women with acne and, if elevated, consideration should be given to antiandrogen therapy. Methods Data were collected from 44 consecutive Caucasian women aged 14 to 38 years. The patients were separated into two groups based on menstrual history. Group 1 had regular menses, and group 2 had oligomenorrhea, defined as menstrual intervals of greater than 36 days. All patients had blood samples drawn on their initial office visit, regardless of the phase of the menstrual cycle, and the levels of total testosterone (TT), biologically active testosterone (BT), and free testosterone (FT) were obtained. Results The serum TT level was 87±41.3 ng/dL (range, 31–150 ng/dL) in oligomenorrheic women and 56±27.5 ng/dL (range 8–107 ng/dL) in eumenorrheic women. There was no statistically significant difference. The serum BT level in oligomenorrheic women was 33±16.9 ng/dL (range, 11–51 ng/dL) and In eumenorrheic women 19±13.6 ng/dL (range, 11–51 ng/dL). This difference was statistically significant (p <0.05). The serum FT level in oligomenorrheic women was 18±9.4 pg/mL (range, 1–29 pg/mL) and in eumenorrheic women 10±7.1 pg/mL (range, 1–32 pg/mL). This difference was not statistically significant (Table 1). Conclusions Women with acne and oligomenorrhea, similar to women with hirsutism and oligomenorrhea, have higher levels of biologically active testosterone than those with normal menses.
The variable incidence of psoriasis in sub‐Saharan Africa
Authors: Leder Richard O. , Farber Mugene M. 
Published: November 2003

abstract background surveys of skin disorders have previously provided information about the prevalence and incidence of psoriasis in sub‐saharan africa; however, the geographic and ethnic trends which may be drawn from these surveys have not been fully described in previous studies, which considered only a fraction of the available data. methods a critical review of clinic‐based surveys of psoriasis incidence and population‐based studies of psoriasis prevalence is presented. the incidence of psoriasis is adjusted, wherever possible, to factor out the widely variable incidence of infectious skin conditions seen in african skin clinics. to distinguish between genetic and environmental factors that may be responsible for the variability of psoriasis incidence, attention is drawn to climate, human leukocyte antigen (hla) frequencies, and language groups across the regions surveyed in sub‐saharan africa. results higher psoriasis incidence rates are consistently observed in eastern africa than in western africa, consistent with more limited data on the prevalence of psoriasis in western africa. neither rainfall/humidity levels nor hla frequencies can simply account for these differences; however, the ethnicities of sub‐saharan african peoples may be observed to parallel roughly the trend in psoriasis incidence. western african countries, such as nigeria, mali, senegal, and sierra leone, where lower rates of psoriasis incidence have been reported (less than 1.0% of skin disorders), are populated mainly by non‐bantu‐speaking ethnic groups. bantu‐speaking peoples constitute a majority in the populations of most countries in eastern and southern sub‐saharan africa, where the incidence of psoriasis varies widely. african americans, whose largely non‐bantu‐speaking african ancestry is shared with modern western africans, also have relatively low psoriasis incidence rates by comparison with north american caucasians. conclusions ethnic correlations both within africa and between north america and africa suggest that unidentified genetic factors, which differ between eastern and western sub‐saharan africans, may govern the differential incidence of psoriasis.
Pigmented skin lesions in tyrosinase‐positive oculocutaneous albinos: a study in black South Africans
Authors: Bothwell Janet E. 
Published: November 2003

Abstract Background The aim of this study was to document the nature, prevalence, and distribution of pigmented skin lesions in tyrosinase‐positive oculocutaneous albinism (typos OCA), the most common recessive disorder in South Africa (overall prevalence, 1 in 3900). Methods Sixty‐one black subjects with ty‐pos OCA (mean age, 23 years) and 65 normally pigmented black control subjects (mean age, 29 years) were studied. Results Pigmented skin lesions not directly related to sun exposure included nevi and pigmented macules on the palms and soles. Melanocytic nevi, mostly on the trunk, were present in 82% of subjects with ty‐pos OCA and in 71% of controls. The mean numbers were, however, greater in the ty‐pos OCA subjects than in the controls (12 and 7, respectively), being closer to those reported in whites. Palmoplantar pigmentation was present in 75% of the control subjects, but in none of those with ty‐pos OCA. The most striking sun‐related lesions were dendritic freckles, which were present in 43% of ty‐pos OCA subjects, and were characterized by an irregular branched shape, light to dark brown color, and large size (0.5–3.0 cm). Clinically, they resembled solar lentigines, but histologically the rete ridges were often flattened and there was no increase in the number of melanocytes. Solar keratoses occurred less frequently in ty‐pos OCA subjects with dendritic freckles (50% vs. 73%), which confirmed the sun‐protective role of the increased ability to form pigment. Conclusions There were two major conclusions. Firstly pigmented nevi occur much more commonly in ty‐pos OCA subjects than was previously thought, being similar in number to those found in white subjects. Secondly, dendritic freckles appear to represent a unique clinical and histologic entity found only on sun‐exposed areas in ty‐pos OCA subjects.
Albendazole: a new therapeutic regimen in cutaneous larva migrans
Authors: Rizzitelli Gaetano , Scarabelli Gabriele , Veraldi Stefano 
Published: November 2003

Abstract Background Various therapeutic modalities have been used to treat cutaneous larva migrans, including physical treatments (cryotherapy), topical drugs (tiabendazole), and systemic drugs (tiabendazole, albendazole, and ivermectin). Physical treatments are often ineffective and not devoid of side‐effects. Topical tiabendazole is difficult to find in many countries; it is effective orally but frequently causes side‐effects. Ivermectin has been used in a small number of patients. Methods Eleven (six men and five women) adult patients with cutaneous larva migrans characterized by multiple and/or diffuse lesions were treated with oral albendazole (400 mg daily for 7 days). No other topical or systemic drugs were used and no physical treatment was given. Results All patients were cured at the end of treatment. No side‐effects were complained of or observed, and no laboratory abnormalities were recorded. No recurrences were observed. Conclusions Albendazole is effective in the treatment of cutaneous larva migrans characterized by multiple and/or diffuse lesions. This new therapeutic regimen can reduce the number of no responses and recurrences, sometimes observed following shorter (e.g. 3–5 days) treatments with albendazole. The longer duration of treatment is not accompanied by the appearance of new and/or more severe side‐effects.