bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short‐term resolution of psoriasis after total thyroidectomy for euthyroid multinodular goitre
Authors: Kuchel Johanna , Barakate Michael , Delbridge Leigh , Agarwal Gaurav , Beattie John , Barnetson Ross 
Published: March 2003

SUMMARYA 36‐year‐old Chinese female with an 8‐year history of chronic, generalized plaque psoriasis demonstrated a marked improvement of the disease after removal of an intercurrent euthyroid multinodular goitre. Thyroxine was commenced immediately postoperatively. No thyroid antibodies were detected and thyroid function and calcium levels remained within normal limits both pre‐ and postoperatively. Four weeks following surgery, narrow‐band ultraviolet B (nbUVB) therapy was recommenced for recurrent psoriasis. The manifestations of psoriasis at this stage were less severe than before thyroidectomy and responded well to treatment, whereas before surgery the response to therapy had been poor. One year following total thyroidectomy, the patient received very effective psoriasis control with nbUVB therapy. The possible role of surgery and thyroid hormones in altering the pathogenesis of psoriasis in the acute setting is clearly of interest and warrants further research consideration.
Thalidomide in dermatology
Authors: Wines Nina Y , Cooper Alan J , Wines Michael P 
Published: March 2003

SUMMARYThalidomide is an effective agent to treat over 25 seemingly unrelated dermatological conditions that have an inflammatory or autoimmune basis. The main side‐effects of teratogenesis and peripheral neuropathy limit its use. Currently, in Australia no assurance is given as to the quality, safety and efficacy of thalidomide. The use of thalidomide for toxic epidermal necrolysis can lead to an increase in mortality, and its use as a prophylactic agent for the prevention of chronic graft‐versus‐host disease following bone marrow transplantation has raised more speculations as to the safety of this notorious drug. A review of the therapeutic indications for thalidomide in dermatology as well as the mechanisms of action and side‐effects of this drug are presented. The current suggested guidelines for its use in clinical practice in Australia are discussed.
Atopic dermatitis: Review of immunopathogenesis and advances in immunosuppressive therapy
Authors: Meagher Linton J , Wines Nina Y , Cooper Alan J 
Published: March 2003

SUMMARYThis paper reviews the theories of the pathogenesis of atopic dermatitis (AD), with a particular emphasis on its immunopathogenesis. The contribution of predisposing factors, immunopathogenic factors and provoking factors in the pathogenesis of AD are considered. Predisposing factors explored in this article include genetics and the disturbance of skin function. Immunopathogenic factors reviewed include T cell dysfunction, biphasic cytokine expression and the role of immunoglobulin E. Provoking factors considered include microbial factors, psychosomatic interactions, contact allergens and irritants, inhalant allergens, food and climate. Immunosuppressive treatments reviewed include cyclosporin, azathioprine, methotrexate, tacrolimus, interferon‐γ, phosphodiesterase inhibitors and pimecrolimus (SDZ ASM 981).
Cost of psoriasis: A study on the morbidity and financial effects of having psoriasis in Australia
Authors: Jenner Nicole , Campbell Jan , Plunkett Anne , Marks Robin 
Published: March 2003

SUMMARYEighty‐three participants with psoriasis were followed over a 2‐year period assessing the severity, morbidity and cost of their disease over time. At recruitment, they were examined by a dermatologist who classified them on a global basis as mild (47%), moderate (35%) or severe (18%). A Psoriasis Area and Severity Index (PASI) score was also recorded at the initial interview. Participants completed questionnaires on the morbidity related to having psoriasis using the Psoriasis Disability Index (PDI) and a self‐administered PASI (SAPASI) score at the initial interview and at 3‐monthly intervals over the 2‐year period. During the 3‐monthly follow ups, patients also collected information on the cost of treatment. Using the PDI data, two‐thirds of the respondents said that, as a result of their psoriasis, they altered the way they carried out their normal daily activities; more than 50% wore different types or colours of clothing; more than 50% said their home was made more messy or untidy; and over a third had problems at the hairdresser or difficulties playing sport. The annual out‐of‐pocket expense for medical products was around AUD$250 per person, with costs ranging from zero to more than AUD$2000 per individual over the 2‐year period. Costs were highest for over‐the‐counter products purchased without a medical prescription. There were similar variations in the out‐of‐pocket expenses of medical consultations depending on the level of medical care required. The study revealed that the standard methods used for classification of severity of psoriasis, such as the PASI or SAPASI scores, do not take into account the treatment being used at the time the score is recorded and therefore may not accurately reflect the true severity.
Porphyria cutanea tarda in south‐east New South Wales
Authors: McCrossin Ian 
Published: March 2003

SUMMARYThirteen patients with porphyria cutanea tarda diagnosed between 1994 and 2000 were reviewed to evaluate the precipitating factors and associations of porphyria cutanea tarda in a regional area of coastal and rural NSW. The majority had more than one precipitating factor, with excess alcohol intake, mutations in the haemochromatosis gene, chronic hepatitis C infection and oestrogen therapy being the most common. Antibodies to the hepatitis C virus were detected in 25% and these patients presented at a younger age. Of the patients tested for the two known haemochromatosis gene mutations, six (46%) had at least one copy of the C282Y mutation. Two (15%) patients were homozygous for the C282Y mutation and two (15%) were compound heterozygous for the C282Y and H63D mutations. All patients responded to venesection, which is the treatment of choice for the majority of patients with porphyria cutanea tarda.
Birt–Hogg–Dubé syndrome and multinodular goitre
Authors: Drummond Catherine , Grigoris Irene , Dutta Bish 
Published: March 2003

SUMMARYA 50‐year‐old woman presented with multiple skin‐coloured facial papules. There was a family history of similar lesions. Histology of one of these papules was consistent with fibrofolliculoma. Multiple fibrofolliculomas together with flexural acrochordons suggested the diagnosis of Birt–Hogg–Dubé syndrome. Investigations to exclude associated disease revealed changes consistent with multinodular goitre on thyroid ultrasound. The literature regarding the association of Birt–Hogg–Dubé syndrome with internal disease is reviewed.
Factors supporting sustainability of a community‐based scabies control program
Authors: Wong Li‐Chuen , Amega Beth , Barker Ruth , Connors Christine , Dulla Mary Elizabeth , Ninnal Angela , Cumaiyi Margaret Mary , Kolumboort Loyola , Currie Bart J 
Published: March 2003

SUMMARYScabies remains a major problem in Aboriginal communities within the Northern Territory of Australia. Secondary skin infection with Group A streptococcus (GAS) is very common and post‐streptococcal disease rates remain high. Treating families in isolation will have only limited success, as reinfection frequently occurs as a result of the high levels of movement between households and communities. We describe the results of a successful community intervention to reduce scabies and GAS skin infection in one of the largest Aboriginal communities in the Northern Territory, 15 months post‐intervention, and we discuss factors that have led to the success and sustainability of the program.
Benign familial pemphigus: Little benefit from superficial radiotherapy
Authors: Roos Daniel E , Reid Catherine M 
Published: March 2003

SUMMARYBenign familial pemphigus (Hailey–Hailey disease) is a rare relapsing–remitting epidermal blistering disease palliated by a multitude of medical and surgical treatments. There are limited reports of benefit from low‐penetration X‐rays. We describe two resistant cases that appeared to respond initially to superficial radiotherapy, a 66‐year‐old man who had multiple courses to the groins (4 × 2.00 Gy/5 × 3.00 Gy) and to the axillae and low back (10 × 2.00 Gy) and a 53‐year‐old man treated twice to the groins and perineum (5 × 3.00 Gy/10 × 2.00 Gy). However, on longer follow up, benefit was found to be questionable. We conclude that while superficial radiotherapy may offer temporary relief, there is little evidence that it alters the natural history of this disease.
Solar keratoses: Analysis in a dermatological practice in Australia
Authors: Rosen Robert H , Studniberg Howard 
Published: March 2003

SUMMARYTwo hundred consecutive patients with solar keratoses (SK) seen in a private dermatology practice had on average 61.9 SK compared with eight reported in the general population. Non‐melanoma skin cancer was present in 41% of patients and 17% had squamous cell carcinoma (SCC). The ratio of basal cell carcinoma to SCC in the cohort was 1.7:1. The commonest site of SK was the upper limbs but the greatest density of lesions was on the face, particularly the nose. Squamous cell carcinomas were most commonly found on the upper and lower limbs. Basal cell carcinomas were most common on the head and neck.
Onychomycosis of toenails: Orthopaedic and podiatric considerations
Authors: Murray Stuart C , Dawber Rodney PR 
Published: March 2003

SUMMARYOnychomycosis is common, affecting approximately 5% of the population, and is the most resistant form of superficial fungal infection. Dermatologists often view the nail apparatus in static terms and unfortunately give little consideration to the functional aspects of the digit. In the case of toenails, it is important to consider the toes and foot as a closely integrated functional unit. It is essential that in any case of onychomycosis or onychodystrophy that, as clinicians, we have an understanding of foot dynamics, of structure/function relationships and of the implications of orthopaedic/ podiatric factors when evaluating cases of nail dystrophy. When confronted with cases of possible onychomycosis, we must adopt a systematic and sometimes multidisciplinary approach in the evaluation and management of these patients to improve patient outcomes.
Methods of evaluating hair growth
Authors: Chamberlain Alexander J , Dawber Rodney PR 
Published: March 2003

SUMMARYFor decades, scientists and clinicians have examined methods of measuring scalp hair growth. With the development of drugs that stem or even reverse the miniaturization of androgenetic alopecia, there has been a greater need for reliable, economical and minimally invasive means of measuring hair growth and, specifically, response to therapy. We review the various methods of measurement described to date, their limitations and value to the clinician. In our opinion, the potential of computer‐assisted technology in this field is yet to be maximized and the currently available tools are less than ideal. The most valuable means of measurement at the present time are global photography and phototrichogram‐based techniques (with digital image analysis) such as the ‘TrichoScan’. Subjective scoring systems are also of value in the overall assessment of response to therapy and these are under‐utilized and merit further refinement.
Anogenital and buttock ulceration in infancy
Authors: Halbert Anne R , Chan Jonathan J 
Published: March 2003

SUMMARYRashes in the anogenital and buttock region are some of the commonest dermatological problems occurring in infancy. The most frequent causes seen in clinical practice are ulcerating haemangiomas, bullous impetigo and severe irritant contact dermatitis. Other causes include nutritional deficiencies, bullous diseases, trauma, Langerhans cell histiocytoses and inflammatory disorders such as pyoderma gangrenosum and Crohn’s disease. This review presents a brief overview of these causes and outlines the recommended management strategies.
Eosinophilic pustular folliculitis (Ofuji's disease) in Singapore: A review of 23 adult cases
Authors: Tang Mark BY , Tan Eileen , Chua Sze Hon 
Published: March 2003

SUMMARYThe case records of 23 patients with classic eosinophilic pustular folliculitis (EPF), or Ofuji's disease, seen at the National Skin Centre in Singapore, from 1990 to 2001 were reviewed. All patients had clinical and histopathological findings consistent with EPF. There were eight men and 15 women (ratio 1:1.6). The mean age at presentation was 35 years. There was a marked predilection for Chinese patients (87%), with a racial distribution of 20:2:1 of Chinese, Malay and Indian patients, respectively. The most frequent site of occurrence was the face, particularly over both cheeks. The majority of patients (90%) treated with oral indomethacin had a good response within 2–4 weeks. Relapses were frequent in 82.6% of patients and maintenance with indomethacin or ketoprofen was beneficial. Eosinophilic pustular folliculitis is a rare but important disease entity presenting with recurrent indurated erythematous papulopustules and plaques on the face. Increased awareness of this condition is important as it can mimic many other conditions presenting as red plaques on the face.
Birt–Hogg–Dubé syndrome
Authors: Godbolt Amanda M , Robertson Ivan M , Weedon David 
Published: March 2003

SUMMARYWe present three members of a Queensland family with clinical and histopathological features consistent with Birt–Hogg–Dubé syndrome. Two of the three family members were able to be screened for associated disorders. The mother of the family was found to have a solitary colonic polyp, a large ovarian cyst and two chorioretinal scars. No associated disorders were found on investigation of one of the two affected sons.
Androgenetic alopecia in a postmenopausal woman as a result of ovarian hyperthecosis
Authors: Kim Youngjin , Marjoniemi Veli‐Matti , Diamond Terry , Lim Adrian , Davis Greg , Murrell Dedee 
Published: March 2003

SUMMARYA 65‐year‐old woman presented with an 8‐year history of progressive frontotemporal alopecia and hirsutism. She had elevated serum levels of testosterone, androstenedione and estradiol. Ultrasound and computed tomography imaging suggested a right ovarian mass, while bilateral ovarian venous sampling demonstrated increased testosterone levels originating from both ovarian veins. Histology obtained following bilateral oophorectomy demonstrated bilateral ovarian hyperthecosis. Six months after surgery, the patient remains well with no progression of the alopecia. Ovarian hyperthecosis is a rare cause of androgenetic alopecia in postmenopausal women. The role of hyperthecosis and its relationship to androgenetic alopecia is reviewed.
O'Brien's actinic granuloma in association with prolonged doxycycline phototoxicity
Authors: Lim Davin S , Triscott Joe 
Published: March 2003

SUMMARYO'Brien's actinic granuloma is clinically characterized by annular papules and plaques on sun‐exposed areas of skin. These lesions often occur insidiously on a background of severe solar elastosis; however, an acute variant following sunburn has been reported in the literature. We present two cases of acute actinic granuloma precipitated by episodes of sunburn occurring on a background of prolonged doxycycline phototoxicity. Biopsies from both patients showed a histiocytic infiltrate with multinucleate giant cells engulfing elastotic material, with a reduction of elastin towards the centre of the papule. Marked resolution of the lesions was noted after 8 weeks of treatment with betamethasone dipropionate 0.05% ointment in optimized vehicle together with adequate photoprotection in the form of broad‐spectrum sunscreens.
Ulcerated juvenile xanthogranuloma of the scalp
Authors: Behne Karen , Casey Terrence 
Published: March 2003

SUMMARYA 7‐month‐old girl presented with a single rapidly enlarging thickly crusted lesion on her frontal scalp. Histology was consistent with a juvenile xanthogranuloma (JXG) with ulceration and surface crust formation. Reports of ulcerating, crusted lesions of JXG are rare and the few reports have been confined to giant forms or those involving mucosal sites. This unusual presentation delayed diagnosis. Our report highlights the great variabilty in clinical presentation of JXG and is a reminder to consider this diagnosis in the differential of any lesion developing in an infant, particularly on the head, neck and upper trunk.
Epidemiology and pathogenesis of scleroderma
Authors: Chen Keng , See Adrian , Shumack Stephen 
Published: March 2003

SUMMARYScleroderma is a heterogenous connective tissue disorder characterized by fibrosis of the skin, with or without internal organ involvement. The aetiology of scleroderma may involve both environmental and genetic factors. Abnormalities involving the immune system, vascular tissue and extracellular matrix have been demonstrated. Recent research has focused on microchimerism as a risk factor for the development of scleroderma. This article reviews the epidemiology and pathogenesis of this disorder.
ROLE OF ABDOMINAL DRAINS IN PERFORATED DUODENAL ULCER PATIENTS: A PROSPECTIVE CONTROLLED STUDY
Authors: Pai D. , Sharma A. , Kanungo R. , Jagdish S. , Gupta A. 
Published: March 2003

Background: Duodenal ulcer perforation is a common emergency in south India, with about 100–120 cases being treated at Jawaharalal Institute of Post Graduate Medical Education and Research each year. The routine to date has been to leave two tube drains: one in the Morrison’s pouch and one in the pelvis after omental patch closure. This study was conducted to test the efficacy and safety of drain usage routinely after duodenal ulcer perforation closure with Roscoe Graham omental patch technique. Methods: In this prospective controlled study, 44 patients formed the test group (without drains) and 75 patients formed the control group (with abdominal drainage). Only patients of perforated duodenal ulcer closed with Roscoe Graham omental patch technique were included in the study. The incidence of postoperative fever, wound infection, time for return of bowel function and duration of hospital stay were noted. Details of drainage noted were the mean amount of daily drainage, mean time of drain removal and occurrence of drain‐related complications. Peritoneal fluid, wound discharges, drain tips and drain wounds were cultured. Abdominal ultrasound was performed in all patients in the second postoperative week or if earlier indicated to detect intra‐abdominal collections. Results: It was found that there was no difference in incidence or duration of postoperative pyrexia, return of bowel function or postoperative hospital stay between the two groups. Routine use of drains was not effective in preventing postoperative fluid collection nor in decreasing the incidence of intra‐abdominal abscesses. The migration of bacteria from the exterior to the peritoneal cavity via the drain was also demonstrated. Drains were found to cause morbidity including intestinal obstruction. Conclusion: The routine use of drains was found to be neither safe nor effective in patients of perforated duodenal ulcer treated by omental patch closure.
Consultative Committee on Road Traffic Fatalities: Trauma Audit Methodology
Authors: McDermott Francis T. , Cordner Stephen M. , Tremayne Ann B. ,   The Consultative Committee on Road Traffic Fatalities in Victoria
Published: March 2003

Background: Since 1992 the Consultative Committee on Road Traffic Fatalities in Victoria has identified deficiencies and errors in the management of 559 road traffic fatalities in which the patients were alive on arrival of ambulance services. The Committee also assessed the preventability of deaths. Reproducibility of results using its methodology has been shown to be statistically significant. The Committee’s findings and recommendations, the latter made in association with the learned Colleges and specialist Societies, led to the establishment of a Ministerial Taskforce on Trauma and Emergency Services. As a consequence, in 2000, a new trauma care system will be implemented in Victoria. This paper presents a case example demonstrating the Committee’s methodology. Methods: The Committee has two 12 member multidisciplinary evaluative panels. A retrospective evaluation was made of the complete ambulance, hospital and autopsy records of eligible fatalities. The clinical and pathological findings were analysed using a comprehensive data proforma, a narrative summary and the complete records. Resulting multidisciplinary discussion problems were identified and the potential preventability of death was assessed. Results: In the present case example the Committee identified 16 management deficiencies of which 11 were assessed as having contributed to the patient’s death; the death, however, was judged to be non‐preventable. Conclusion: The presentation of this example demonstrating the Committee’s methodology may be of assistance to hospital medical staff undertaking their own major trauma audit.
Establishment and growth of seedlings of Eucalyptus obliqua: Interactive effects of litter, water, and pathogens
Authors: Facelli José M. , Williams Richard , Fricker Stephen , Ladd Brenton 
Published: March 2003

AbstractWe studied how leaf litter, water and fungal pathogens affect the establishment, survivorship, and growth of Eucalyptus obliqua using glasshouse and field experiments. In a glasshouse experiment, the presence of leaf litter of E. obliqua increased the establishment of seedlings when the seeds were placed beneath the litter, but dense litter layers reduced seedling emergence when seeds were placed on top. Results from a complementary experiment suggest that the effect of litter may be mediated by the high humidity microenvironment it creates, which may enhance imbibition of unburied seeds. In another glasshouse experiment, litter in combination with excessive water applications reduced seedling emergence and increased seedling mortality, but the addition of fungicide reverted these effects. Litter with lower water application or fungicide added increased seedling emergence. In all cases higher biomass in seedlings growing in litter treatments was associated with earlier emergence. In two recently burnt sites, the density of seedlings of E. obliqua was positively correlated to the presence of litter. Experimental addition of litter in the field reduced soil temperature during the summer, and together with watering, increased soil water content, and the water potential of established seedlings. However, neither treatment had any positive effect on their growth or survivorship. On the contrary, litter addition reduced the height and number of leaves, probably as a result of increased herbivory. We conclude that in Mediterranean‐type systems litter may produce various effects on seedling establishment depending on their developmental stage, and the season.