bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skin pathology findings in a cohort of 1500 adult and elderly subjects
Authors: Siragusa Maddalena , Schepis Carmelo , Palazzo Rosaria , Fabrizi Giuseppe , Guarneri Biagio , Del Gracco Stefano , Spada Rosario S. , Ferri Raffaele 
Published: March 2003

Abstract Background No extensive studies are available in the literature on the eventual skin pathology induced by neurologic or systemic diseases in elderly individuals. Other factors, such as health and hygiene, socioeconomic status, and climate can also play an important role. Methods Fifteen‐hundred subjects (886 women and 614 men; mean age, 67.8 years; range, 39–90 years) were admitted to the Department of Geriatrics at the Oasi Institute between 1992 and 1997; all these subjects were carefully evaluated from a dermatologic point of view. Each subject underwent specialist examinations, routine blood analyses, thoracic X‐rays, cerebral computerized tomography (CT) scan, and magnetic resonance imaging (MRI) when appropriate. A group of subjects without significant neurologic or systemic disease, comprising 116 women and 60 men (mean age, 64.5 years; range, range, 40–90 years), was selected and used as a normal control group. Subsequently, our attention was focused on the eventual presence of the following neurologic diseases: Alzheimer‐type dementia, vascular dementia, mixed‐type dementia, subcortical dementia, Parkinson’s disease, vascular brain disease, hemiplegia, etc. Thus, different subgroups were formed on the basis of such diagnostic categories and the frequency of skin pathology in each subgroup was evaluated. Results Of the 1500 subjects, 1439 stated that they had never been affected by dermatologic disease. No statistically significant difference in frequency of skin pathology was found between normal controls and the different patient subgroups. Unsuspected and singular dermatoses were found, however, such as paraneoplastic syndromes, idiopathic tripe palms, white fibrous papulosis of the neck as an expression of photoaging, conditions induced by former popular traditions of Sicilian culture (anetoderma secondary to the application of Hirudo medicinalis and erythema ab igne), pigmented dermatoses never described before in Italy (prurigo pigmentosa and friction amyloidosis), and nail abnormalities (atypical half‐and‐half nail, and dyschromic nail changes in multiple system atrophy and in hemiplegia). Conclusions The dermatologic screening performed in 1500 patients revealed several unexpected diagnoses and some original observations. Some rare dermatoses were described and certain hypotheses were suggested to explain the peculiar dyschromic changes of the fingernails in multiple system atrophy, the atypical cases of half‐and‐half nail, and the so‐called idiopathic tripe palms associated with psoriasis.
A double‐blind randomized clinical trial of a topical herbal extract (Z‐HE) vs. systemic meglumine antimoniate for the treatment of cutaneous leishmaniasis in Iran
Authors: Zerehsaz Fereidoun , Salmanpour Rahmat , Handjani Farhad , Ardehali Sadreddine , Panjehshahin Mohammad Reza , Tabei Seyed Ziaeddin , Tabatabaee Hamid Reza , Ms . 
Published: March 2003

A double‐blind randomized clinical trial was undertaken to compare the efficacy of meglumine antimoniate solution (Glucantime), administered intramuscularly, with a topical herbal extract consisting of a pure extract mixture of Althaea rosa, Althaea officinalis, and members of the families Leguminosae, Faliaceae, Malvaceae, and Lythraceae (namedZ‐HE) on patients with Old World cutaneous leishmaniasis. The reason for undertaking such a study is that many patients fail to respond to the conventional treatment of cutaneous leishmaniasis (CL), the pentavalent antimonials. Many alternative treatment modalities have been proposed, and one such modality has been the use of herbal extracts applied topically to the lesions. Herbal remedies have been used for a long period of time in Iran for the treatment of many dermatoses, including CL; however, a systematic scientific evaluation of the efficacy of herbal extracts has rarely been performed.A total number of 171 patients who had been referred to the Cutaneous Leishmania Clinic in our center and who were diagnosed as having CL were included in the study. All patients underwent a complete clinical evaluation, and patients were excluded if they were pregnant or nursing or if they had serious concomitant diseases. A diagnosis of CL was based on positive smears from the lesions, and in some cases cultures and histopathologic studies were also performed. The duration of disease in all cases was less than 4 months.The patients were divided randomly into two treatment groups. In the first group (A), 86 patients were treated with the topical herbal extract Z‐HE as a black paste applied to the lesions and covered by a dressing for five consecutive days, as well as with 0.5 mL of sterile normal saline used as a placebo and injected intramuscularly for 20 consecutive days. In the second group (B), 85 patients were treated with meglumine antimoniate (Glucantime), 15–20 mg/kg/day, as intramuscular injections for 20 consecutive days, as well as with a topical placebo which consisted of petrolatum mixed with charcoal powder and which was applied on the lesions as a black paste covered by a dressing for five consecutive days. Prior to the initiation of treatment with Z‐HE, an animal toxicologic study was undertaken and the plant extract was declared safe to use in human clinical trials.Clinical evaluation was performed 6 weeks post‐treatment. Complete cure was defined a clinical improvement with complete healing and re‐epithelialization of the lesion(s), partial cure was defined as partial clinical improvement with reduction in infiltration, erythema, and size of the lesion(s), and failure was defined as the absence of any changes in the lesion(s) or progression and worsening of the lesion(s).
Nodular morphea in a linear pattern
Authors: Hsu Sylvia , Lee Min‐Wei Christine , MPH . , Carlton Soni , Kramer E. Michael , Of Dermatology From the Department , Of Medicine Baylor College , Houston . , Texas . , Of Dermatology Department , Biology Cutaneous , Of Thomas Jefferson Medical College , University Jefferson , Philadelphia . , Pennsylvania . 
Published: March 2003

A 9‐year‐old black girl presented with papules and nodules in a linear distribution on her right inner arm, right axilla, and right chest ( Fig. 1). The lesions were hyperpigmented, indurated, and had been present for 3 years. She was otherwise healthy. A biopsy of one of the lesions revealed a sparse superficial and deep perivascular infiltrate of lymphocytes, compactly arranged collagen bundles in the upper part of the dermis, and abundant mucin throughout the reticular dermis, which was consistent with morphea with dermal mucinosis (
Fig. 2). Biopsy of another lesion revealed classic histologic features of morphea: thickened bundles of collagen crowded in the reticular dermis aligned parallel to the skin surface.Discrete nodules in a linear distribution on the right armimageBiopsy of a lesionimage
Efficacy of lipectomy and liposuction in the treatment of multiple symmetric lipomatosis
Authors: Martínez‐Escribano Jorge A. , Gonzalez Rafael , Quecedo Esther , Febrer Isabel 
Published: March 2003

Abstract Background Multiple symmetric lipomatosis (MSL) is a rare disease characterized by enlarging, symmetric, nonencapsulated, fat deposits mainly on the neck and upper trunk. Liposuction and lipectomy, although palliative, are the treatments of choice, especially indicated when vital structures are compromised. Objective Our purpose was to evaluate the efficacy and safety of liposuction and lipectomy in the treatment of MSL. Methods We have examined two patients diagnosed with MSL who presented with symptoms derived from the compression of vascular, nervous, and/or respiratory tract structures. One was treated with lipectomy and the other with liposuction. Results A rapid resolution of the clinical symptoms was achieved with both therapies. The patient who was treated with lipectomy suffered from a compression of the left brachial plexus by scar tissue as an adverse effect, requiring a second surgical procedure. Liposuction only provoked a mild autoinvolutive hematoma in the other case. No clinical recurrences were observed at 3 and 2 years of follow‐up respectively. Conclusions We consider both lipectomy and liposuction as safe and effective techniques for the treatment of MSL patients. Although liposuction is usually associated with less adverse effects than lipectomy, location of the lipomas must be carefully considered before choosing one technique over another.
Re‐evaluation of the natural course of bullous pemphigoid. A prospective study
Authors: Kyriakis Kyriakos P. , Paparizos Vassilios A. , Panteleos Demetrius N. , Tosca Androniki D. 
Published: March 2003

Abstract Background Few studies of prospectively collected data regarding the natural course of bullous pemphigoid have been performed. Methods The following factors were combined both quantitatively and qualitatively to obtain results: gender, clinical activity based on the estimation of the body area involvement, disease duration, relapses, coexistence with other disease states, and serology Twenty‐seven consecutive patients were followed up for 1 year. Results Most disease activity (85.2%) is exhibited in the first year after onset. There is a lack of parameters with clear predictive significance. The extent and severity of skin involvement are equally distributed between the sexes and not affected by the disease duration. The generalized form of the disease is predominant (86.5%). The average clinical activity in relapses within the year of follow‐up is 48% of the initially observed attack. The probability for recurrence is higher in seropositive patients (overall 37%). Coexistence with other disease states seems to be a random chance event. Conclusions The lack of parameters with predictive importance underlines the necessity of a thorough follow‐up to prevent treatment‐related complications in elderly patients.
Maggot therapy for the treatment of intractable wounds
Authors: Mumcuoglu Kosta Y. , Ingber Arieh , Gilead Leon , Stessman Jochanan , Friedmann Reuven , Schulman Haim , Bichucher Hellen 
Published: March 2003

AbstractBackground Fly maggots have been known for centuries to help debride and heal wounds. Maggot therapy was first introduced in the USA in 1931 and was routinely used there until the mid‐1940s in over 300 hospitals. With the advent of antimicrobiols, maggot therapy became rare until the early 1990s, when it was re‐introduced in the USA, UK, and Israel. The objective of this study was to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds and ulcers in long‐term hospitalized patients in Israel.Methods Twenty‐five patients, suffering mostly from chronic leg ulcers and pressure sores in the lower sacral area, were treated in an open study using maggots of the green bottle fly, Phaenicia sericata. The wounds had been present for 1–90 months before maggot therapy was applied. Thirty‐five wounds were located on the foot or calf of the patients, one on the thumb, while the pressure sores were on the lower back. Sterile maggots (50–1000) were administered to the wound two to five times weekly and replaced every 1–2 days. Hospitalized patients were treated in five departments of the Hadassah Hospital, two geriatric hospitals, and one outpatient clinic in Jerusalem.The underlying diseases or the causes of the development of wounds were venous stasis (12), paraplegia (5), hemiplegia (2), Birger’s disease (1), lymphostasis (1), thalassemia (1), polycythemia (1), dementia (1), and basal cell carcinoma (1). Subjects were examined daily or every second day until complete debridement of the wound was noted.Results Complete debridement was achieved in 38 wounds (88.4%); in three wounds (7%), the debridement was significant, in one (2.3%) partial, and one wound (2.3%) remained unchanged. In five patients who were referred for amputation of the leg, the extremities was salvaged after maggot therapy.Conclusions Maggot therapy is a relatively rapid and effective treatment, particularly in large necrotic wounds requiring debridement and resistant to conventional treatment and conservative surgical intervention.
Atypical cutaneous lymphocytic infiltrate and a role for quantitative immunohistochemistry and gene rearrangement studies
Authors: Fucich Lee F. , Freeman Scott F. , Boh Erin E. , McBurney Elizabeth , Marrogi Aizen J. 
Published: March 2003

Abstract Aim To help clarify the significance of the T‐cell receptor (TCR) gene rearrangement and its relationship to the immunophenotyping of histologically atypical cutaneous T‐cell lymphoid infiltrates (ACLIs). Materials and methods One hundred and twenty‐four patients presented with lesions clinically suspicious for cutaneous T‐cell lymphoma (CTCL). The average age was 55.8 years with a mean follow‐up duration of 26.2 months. Cases were classified as malignant (64 cases), inflammatory dermatosis (28 cases), and indeterminate (32 cases), based on follow‐up data and histopathology. Quantitative immunophenotyping with computer‐assisted imaging was performed using immunohistochemical stains of anti‐CD3, CD4, CD5, CD7, CD8, CD20, CD30, CD56, CD68, Bcl‐2, p53, and proliferating cell nuclear antigen (PCNA). Results Abnormal immunophenotypic expression in 87.5% of the malignant cases, including CD4 or CD8 predominance (67%), deletion of pan‐T‐cell antigens (16.1%), and activation of antigen/oncogene expression (47%), was observed. In addition, 36 clinically malignant cases displayed rearranged bands by polymerase chain reaction (PCR) with TCR β and γ. Two benign cases displayed abnormal immunophenotype and two others showed rearranged bands. All of these patients responded to topical steroid therapy with complete resolution. Nineteen indeterminate cases displayed either rearranged bands or immunophenotypic abnormalities, 15 of which were reclassified as malignant. All but three patients improved after CTCL treatment. Conclusion Quantitative immunophenotyping and gene rearrangement analysis can provide detailed information for classifying ACLIs with 91% diagnostic sensitivity and 87% specificity.
High prevalence of vitiligo in lepromatous leprosy
Authors: Boisseau‐Garsaud Anne‐Marie , Vezon Géraldine , Helenon Raymond , Garsaud Philippe , Saint‐Cyr Isabelle , Quist Danielle 
Published: March 2003

Abstract Background  Leprosy and vitiligo are common affections in the West Indies. Vitiligo frequently occurs in lepromatous patients, an observation rarely reported in the literature.Methods  We studied the prevalence of vitiligo in patients affected by leprosy by performing a retrospective study between 1978 and 1999 in the French West Indies (Martinique).Results  Eleven patients presented with vitiligo among 101 with lepromatous (multibacillary) leprosy. None presented with vitiligo among the 364 with the tuberculoid (paucibacillary) form. The mean age of the vitiligo patients was 55.4 years at vitiligo onset. The sex ratio was 0.8. Vitiligo occurred 19 years after the diagnosis of leprosy, with a range from 3 to 42 years. The prevalence of vitiligo in lepromatous patients was 10.9%, compared to 0% in tuberculoid patients. Such an increase in prevalence compared with that in the general population (0.34%) was shown to be highly significant (P < 0.0001).Conclusions  Our data confirmed that the association of vitiligo and leprosy was not fortuitous. The physiopathology leading to this high rate of vitiligo in lepromatous leprosy is unclear, despite the fact that autoimmunity plays a major role in both diseases.
Pulsed erbium:YAG laser‐assisted autologous epidermal punch grafting in vitiligo
Authors: Sachdev Mukta , Shankar D. S. Krupa 
Published: March 2003

AbstractBackground  A pilot study was conducted to evaluate the efficacy and safety of pulsed erbium:YAG laser ablation of autologous minipunch grafted sites for the treatment of refractory or stable vitiligo.Methods  Thirteen patients, seven men and six women, aged between 19 and 58 years, with Fitzpatrick skin types ranging from type IV to VI, were grafted. The pulsed erbium: YAG laser was used to create recipient graft sites.Results  Repigmentation was observed in 12 out of 13 patients. Failure of grafts to repigment ranged from 3% to 100%. No untoward side‐effects of surgery were noted.Conclusions  Using an erbium:YAG laser to create graft recipient sites permits the survival of punch harvested grafts and the spread of pigmentation to the surrounding skin.
Cutaneous lymphomas in Tokyo: analysis of 62 cases in a dermatology clinic
Authors: Ishiji Takaoki , Takagi Yuko , Niimura Michihito 
Published: March 2003

Abstract Background The epidemiology of cutaneous lymphomas revealed that the incidence of lymphomas differed depending on various factors including area, race, and sex, among others.Objective  This study was undertaken to analyse the incidence of cutaneous lymphomas in Tokyo.Methods  The clinical records and histologic material from 50 patients with lymphomas of the skin and 12 patients with lymphomatoid papulosis seen during the last 10 years at the Department of Dermatology, The Jikei University School of Medicine, Tokyo, have been reviewed.Results  T‐cell lymphomas including mycosis fungoides (MF)–Sézary's syndrome (SS) complex and adult T‐cell leukemia/lymphoma (ATL) were more frequent than B‐cell lymphomas. The incidence of ATL is associated with the number of human T‐cell lymphotropic virus type 1 (HTLV‐1) carriers in the general population. Cutaneous B‐cell lymphoma (CBCL) is not as rare as previously thought in Japan.Conclusions  Although the frequency of these cases depends on many unrelated factors, these values can provide a rough indication of the incidence of cutaneous lymphomas in Tokyo. The incidence of cutaneous lymphomas may be influenced by changes in environmental factors including viral infections.
Suspected skin malignancy: a comparison of diagnoses of family practitioners and dermatologists in 493 patients
Authors: Morrison Antoinette , O'Loughlin Sean , Powell Frank C. 
Published: March 2003

AbstractBackground  In the Irish health system, dermatology patients present to their family practitioner for diagnosis and treatment, and are referred to a dermatologist for a second opinion where diagnosis is in doubt or when there has been therapeutic failure. The level of expertise in dermatology amongst family practitioners varies considerably.Aim  To compare the diagnoses of general practitioners and dermatologists over a selected period in patients with a possible diagnosis of skin cancer.Methods  Four hundred and ninety‐three patients were seen by one of two dermatologists over a 1‐year period at a rapid referral clinic for patients suspected by their family practitioners of having unstable or possibly malignant skin lesions; 213 of these patients had a diagnosis made on clinical examination by the dermatologist, while 264 had diagnostic or therapeutic biopsies performed; 16 patients defaulted on surgery.Results  The diagnoses of the family practitioners agreed with the diagnoses of the dermatologists on patients diagnosed clinically in 54% of cases. Thirty‐eight patients had histologically proven skin malignancy. These were diagnosed accurately by the referring family practitioner in 22% of patients, while the dermatologists made the correct diagnosis prior to biopsy in 87%.Conclusions  In over 50% of cases diagnosed clinically, the dermatologist and family practitioner agreed. Histologically proven skin cancers were diagnosed accurately in only 22% of cases by family practitioners, compared to 87% of cases by dermatologists. Specific areas of diagnostic difficulty for family practitioners include benign pigmented actinic and seborrheic keratoses, squamous cell carcinoma, and melanoma. Postgraduate education for family practitioners should be directed towards these areas of deficiency. Dermatologists had difficulty distinguishing pigmented actinic keratoses from melanoma.
Azone® enhances clinical effectiveness of an optimized formulation of triamcinolone acetonide in atopic dermatitis
Authors: Cato Allen , Swinehart James M. , Griffin Edmond I. , Sutton Lynda , Kaplan Allan S. 
Published: March 2003

AbstractBackground  Atopic dermatitis is a chronic, relapsing condition affecting up to 14% of the population in Western countries. Topical corticosteroids are the mainstay of treatment. Triamcinolone acetonide, a corticoid of intermediate potency, has proven useful in the treatment of atopic dermatitis.Aim  To evaluate the effectiveness of a triamcinolone acetonide–laurocapram combination in the treatment of atopic dermatitis.Methods  One hundred and fifty patients were enrolled in a three‐arm, parallel group, controlled clinical trial evaluating the effectiveness of a triamcinolone acetonide (0.05%) and laurocapram combination, applied twice daily for 2 weeks, in the treatment of atopic dermatitis. Fifty patients received triamcinolone acetonide–laurocapram (TNX), 50 triamcinolone acetonide (TN), and 50 a vehicle control formulation (AN). Response to treatment was evaluated by change in disease severity at 6 h, at 3, 8, and 15 days after the start of treatment, and by the global change in disease status.Results  TNX effected a significantly higher degree of improvement in the signs and symptoms of atopic dermatitis (erythema, induration, and pruritus) and a greater overall improvement in disease status compared with treatment with TN or AN. Treatment‐associated side‐effects were local reactions, occurring in three, two, and six patients in the TNX, TN, and AN groups, respectively.Conclusions  The results suggest that the incorporation of laurocapram in the formulation enhances the effectiveness of triamcinolone acetonide, without compromising its safety profile.
Psoriasis and side‐effects of mesotherapy
Authors: Rosina Paolo , Chieregato Carlo , Miccolis Domenico , D'Onghia Francesco Saverio 
Published: March 2003

A 67‐year‐old woman was referred to our Department in January 1997 with an isomorphic Koebner response due to mesotherapy.The patient has been affected by psoriasis for 10 years and underwent treatment with Cyclosporine A (4–2 mg/kg/day for 12 weeks) 2 years earlier. Since the previous year plaques were treated only with topical preparations, with mild worsening over the autumn.In December 1996 a single mesotherapy was erroneously performed with a cocktail of aminophilline, xantinol nicotinate and lidocaine to treat a left neuralgic sciatica. Two weeks later typical circular psoriatic lesions appeared on the left thigh in the injection's sites (Fig. 1). At the same time, psoriasis worsened on the scalp, trunk, and limbs, while pustular lesions appeared on the palms and soles. The patient was admitted to our Department and underwent treatment with Cyclosporine A with a rapid response (4 mg/kg/day in divided doses for 3 weeks reduced gradually to 2 mg/kg/day and stopped after 14 weeks). Clinical and laboratory examinations excluded further trigger factors for psoriasis.Isomorphic Koebner response where mesotherapy was performed.image