bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a new sensitive and efficient multiplex polymerase chain reaction (PCR) for identification and differentiation of different mycobacterial species
Authors: Bhattacharya Basudev , Karak Kalpana , Ghosal Alok Gopal , Roy Atanu , Das Shyamal , Dandapat Premanshu , Khetawat Dimple , Mondal Dibya Kanti , Bhattacharya Sujit , Chakrabarti Sekhar 
Published: March 2003

SummaryFor early detection and species differentiation of mycobacteria, polymerase chain reaction (PCR) techniques are currently in wide use. However, individual techniques using amplification of different targets with appropriate primers still have some limitations, which have to be overcome. The ideal technique would use DNA sequences which should be present in all mycobacteria and absent in others and would be able to discriminate one species from the other, as non‐tuberculous mycobacteria (NTM) are on rise in terms of frequency of detection. We developed a multiplex PCR based on amplification of 165, 365 and 541 bp target fragments of unrelated genes, hsp 65 coding for 65 kDa antigen, dnaJ gene of mycobacteria and insertion element IS 6110 of Mycobacterium tuberculosis, respectively. This multiplex PCR was tested over 5 years from 1996 to 2001 with 411 clinical specimens from suspected cases of tuberculosis and mycobacterioses and compared with standard laboratory techniques. The multiplex PCR was positive for 379 cases compared with 280 cases by standard techniques (P < 0.0001). It could distinguish between strains of the M. tuberculosis complex and NTM; the results are comparable with standard techniques. Thus the multiplex PCR can be useful in early detection, species differentiation and epidemiology.
PCR‐based detection ofPythiumandLagenidiumDNA in frozen and ethanol‐fixed animal tissues
Authors: Znajda Nadine R. , Grooters Amy M. , Marsella Rosanna 
Published: March 2003

Abstract The purpose of this study was to evaluate the application of previously describedPythium insidiosum‐andLagenidium‐specific nested PCR assays to the detection of oomycete DNA in animal tissues. DNA was extracted from 15 frozen and 10 ethanol‐fixed tissues obtained from six animals with pythiosis, five animals with lagenidiosis, one animal with nonoomycotic skin disease and two animals without skin disease. First‐round PCR, which utilized universal fungal primers ITS1 and ITS2P, amplified a single product of the expected size for each of theP. insidiosum‐andLagenidium‐infected tissues, but not for tissues obtained from animals without fungal disease. Second‐round PCR using theP. insidiosum‐specific primers PI1 and PI2 produced a single 105‐bp product for theP. insidiosum‐infected tissues, but not for any of the other tissues. Second‐round PCR using theLagenidium‐specific primers LAG1 and LAG2 produced a single 76‐bp product for theLagenidium‐infected tissues, but not for any of the other tissues.
An approach to the treatment of psychogenic parasitosis
Authors: Zanol Karen , Slaughter James , Hall Robert 
Published: March 2003

BackgroundPatients with psychogenic parasitosis typically seek help from nonpsychiatric physicians and can be difficult and time‐consuming to treat. Pimozide has been promoted as the treatment of choice but is not indicated for every patient presenting with this symptom. Our purpose was to develop a realistic treatment protocol for the nonpsychiatric physician faced with these patients. MethodsUsing what is known about this problem through review of the literature and our own experience with 20 patients, a practical treatment strategy is suggested. ResultsIt is proposed that dermatologists and primary care professionals seeing these patients determine (1) whether or not the patient's belief in infestation is shakable and (2) whether or not the patient is depressed, in order to chose a therapeutic plan. ConclusionsDermatologists and psychiatrists can work together to develop treatment protocols that minimize risk and maximize therapy for patients with psychogenic parasitosis.
Superficial disseminate porokeratosis in a patient with myelodysplastic syndrome
Authors: Levin Robin M.. , Heymann Warren R.. 
Published: March 2003

NJ 08053[TAB]A 70‐year‐old man was admitted with a diagnosis of myelodysplastic syndrome (MDS) and fever of unknown origin. He had been diagnosed with MDS 2 months prior to admission, and was treated initially with the anabolic androgen, Danazol. He had also been on prednisone, 60 mg a day for a few months for the treatment of hemolytic anemia. Two weeks later, he noted the development of a mildly pruritic rash over his trunk and extremities. He denied any previous history of a similar rash as well as any family history of similar lesions. It was thought that he was having an allergic reaction to the Danazol and, therefore, Danazol was discontinued. The rash seemed to improve but flared again a few days prior to admission. Upon admission, his laboratory data revealed hemoglobin 9.3 gm/DL, hematocrit 27.3%, white blood cell count 3300/mm3 and platelet count 41,000/mm3. A bone marrow biopsy showed a hypercellular marrow. Chromosome analysis of the bone marrow revealed a complex karyotype including the loss of chromosomes 5 and 7, the presence of an isochromosome for the entire long arm of chromosome 17, and the presence of an additional chromosome 21; these are characteristic chromosome aberrations in myelodysplastic syndromes. Physical examination demonstrated discrete, small, thread‐like, annular papules over the trunk and extremities (
Fig. 1). A skin biopsy was performed and was compatible with porokeratosis showing a typical cornoid lamella (
Fig. 2). He was not given any treatment for his skin lesions and treatment for his MDS consisted solely of red cell concentrates.Multiple annular papules with a thread‐like border as seen in porokeratosisimageA typical cornoid lamella characteristic of porokeratosisimage
Angina bullosa hemorrhagica
Authors: Grinspan David , Abulafia Jorge , Lanfranchi Héctor , DDS . 
Published: March 2003

Abstract Background In 1967, Badham used the term angina bullosa hemorrhagica (ABH) to describe an entity we already knew as traumatic oral hemophlyctenosis (TOH) (1933) and later renamed recurrent oral hemophlyctenosis (ROH) (1971). Objectives The objective of this study was to review and discuss the literature, and to report 54 new cases seen between 1989 and 1996. Materials and methods Fifty‐four patients were thoroughly assessed to determine the clinical features, histology, etiology, pathogenesis, differential diagnosis, and therapy. Results In 35 patients (64.8%), the lesions predominated on the palate and in nine (16.6%) on the oral mucosa. The incidence was similar in both sexes (women, 52%; men, 48%) and the condition affected mostly the 51–70‐year age group. ABH was never documented in children under 10 years of age. In 24 cases (44.4%), diabetes mellitus, hyperglycemia, and/or a family history of diabetes was found. Conclusions ABH is a disorder more common than the literature would suggest. Although the causes may be multiple (mucosal trauma, inhaled corticosteroids), the available data indicate that, in these patients, the presence of an alteration in glucose metabolism should be considered.
Childhood, neonatal, and stillborn pemphigus vulgaris
Authors: Bjarnason Bolli , Flosadóttir Ellen , Dds . 
Published: March 2003

Abstract Background Childhood, neonatal, and stillborn cases of pemphigus vulgaris were reviewed. Methods From an examination of the pemphigus vulgaris literature, 46 childhood cases, nine neonatal cases, and three stillborn cases were found and investigated. Results In the childhood cases, the ratio between the sexes is approximately the same. The mean age of onset is 12 years, with only 11 children being 10 years of age or younger. Some children were treated with adjuvants to corticosteroids, most of them with azathioprine. While only one childhood case has been reported as fatal, the long‐term prognosis and the relationship of early treatment and outcome are unknown. Neonatal prognosis, however, is excellent. Both neonatal and stillborn cases are probably the result of transplacental transmission of maternal antibodies. The connection between maternal antibody titer and fetal mortality is unknown. All stillborn cases reviewed died during the eight month of gestation. Immunosuppressive treatment probably affects fetal survival. In women with an active disease, who have had the disease, or who are monozygotic siblings to such patients, the possibility of the fetus developing the disease must be considered. Conclusions It is essential that physicians be aware of the existence of childhood pemphigus vulgaris in order to make an early diagnosis and to avoid treatment delay. More childhood case reports are needed to obtain better information on optimal treatment, and authors should be encouraged to report the follow‐up of their cases.
Plaque‐type blue nevus combined with nevus spilus and smooth muscle hyperplasia
Authors: Park Young Min , Kang Hoon , Cho Baik Kee 
Published: March 2003

A 31‐year‐old man presented with a large pigmented lesion, present since birth on his right upper aspect of his back. On examination, a speckled pigmented plaque measuring 9 × 5 cm was found on the right interscapular area. The plaque was composed of multiple dark‐blue macules and papules with intervening areas of faint blue discoloration and brown patches overlapping the blue lesions ( Fig. 1). The lesion was slightly elevated, showing a gradual increase in height from its periphery toward its center. The lesion had enlarged as the patient grew, but there had been no change in color, size, or texture over the past few years. No other pigmentary changes were noted, and there was no family history of pigmentary disorders.A large speckled plaque composed of an aggregation of many deep blue macules, papules and small brown patches with intervening areas of faint blue discolorationimageThree skin biopsy specimens were obtained. In the dark‐blue papular and macular area, many melanin‐laden cells were present in the mid to lower portion of the dermis; these aggregated around blood vessels, the cutaneous nerve, and the pilosebaceous apparatus, and were intimately mixed with irregularly arranged, slightly thickened collagen bundles ( Fig. 2). Many were spindle‐shaped, bipolar, dendritic melanocytes, some extending into the subcutaneous tissue. A few melanophages were intermingled with the melanocytes. Some sections contained proliferations of thickened arrector pili muscles. In the brown patches overlapped by the faint blue background area, rete ridges were elongated and the levels of melanin and melanocytes in the epidermal basal layer were slightly increased. Numerous melanocytes were scattered in the mid to lower dermis. These features were consistent with a common blue nevus accompanied by nevus spilus and smooth muscle hyperplasia.(A) Clumps of melanocytes intermingled with irregularly arranged collagen bundles in the mid and lower dermis. (B) Smooth muscle hyperplasia around pilar structures in the lower part of the dermis. Hematoxylin and eosin. Original magnification: A, ×40; B, ×400imageImmunohistochemical studies demonstrated a positive reaction of the tumor cells to vimentin and S‐100 protein. In addition, many cells reacted to the antibody HMB‐45, indicating the presence of premelanosomes. The patient did not wish to undergo surgical treatment, and it was recommended that the condition be monitored regularly to detect promptly any malignant changes.
T‐cell chronic lymphocytic leukemia mimicking dermatomyositis
Authors: Nousari Hossein C. , Kimyai‐Asadi Arash , Huang Chia‐Hui V. , Tausk Francisco A. 
Published: March 2003

A 57‐year‐old man was diagnosed with chronic lymphocytic leukemia (CLL) during routine hematologic evaluation. Two months later, the patient developed a mildly pruritic periorbital eruption and erythematous plaques in a photosensitive distribution. A skin biopsy at an outside institution showed nonspecific histopathologic changes. The patient was diagnosed with amyopathic dermatomyositis and treated with prednisone 1 mg/kg/day with no improvement. The patient was subsequently admitted to our institution for CLL chemotherapy.Physical examination on admission revealed bilateral, violaceous, nonblanching periorbital plaques (Fig. 1A)and symmetric erythematous plaques with mottled hypo‐ and hyperpigmentation on the shoulders, proximal arms (Fig. 1B), and upper chest (Fig. 1C). Periungual erythema was noted. Muscle strength was normal. Laboratory examination was significant for a white cell count of 33,700/mm3 with 78% lymphocytes, a hematocrit of 25.8%, and a platelet count of 25,000/mm3. The lymphocytes were almost exclusively CD4 T cells expressing CD2, CD3, CD5, and CD7. Electrolytes, liver function tests, creatine kinase, aldolase, antinuclear antibodies, and anti‐Jo antibodies were normal or negative. Several biopsies of the plaques on the arms were obtained. Histopathology revealed leukemic infiltration of the skin with monoclonal T lymphocytes positive for CD2, CD3, CD4, CD5, and CD7 (
Fig. 2). Steroids were discontinued. The patient died a week later from toxic epidermal necrolysis secondary to allopurinol.Clinical findings included periorbital violaceous plaques mimicking a heliotrope eruption (a) and poikilodermatous‐appearing plaques on the lateral arms (b) and upper chest (c)imageimageimageHistopathology of a biopsy from the arm revealing dense dermal leukemic infiltrates with periadnexal accentuationimage
Search for evidence of a Th2 profile in HIV+ patients
Authors: Galhardo Maria Clara Gutierrez , Perez Maurício , Morgado Mariza Gonçalves , Almeida Sônia , De Azevedo Lúcia Maria Soares , Georg Ingerborg , Ferreira Helen , Sarno Euzenir Nunes 
Published: March 2003

Abstract Background Hypersensitivity dermatoses are common in human immunodeficiency virus‐positive (HIV+) patients, particularly as the disease progresses. Studies have shown that a switch to T‐helper 2 (Th2) might represent a turning point in HIV. This study investigated whether increases in the number of skin mast cells, immunoglobulin E (IgE) serum levels, and eosinophilia, involved in the Th2 response in allergic disease, might also be present in HIV+ patients. If so, these alterations might explain one of the mechanisms of skin hypersensitivity in these patients. Methods Forty‐five skin biopsies from the normal skin of the upper arm of HIV+ patients and 15 controls were included in the study. HIV+ individuals were classified into three equal categories according to their immunologic status: Category I (< 200/μL), Category II (200–499/μL), and Category III (> 500/μL). Anti‐tryptase antibody was employed in tissue sections to show mast cells; IgE serum levels and eosinophils in peripheral blood count were investigated; delayed‐type hypersensitivity (DTH) skin tests (candidin, trichophytin, and PPD 2U) were evaluated. Results Normal cutaneous mast cell and eosinophil counts were the same in all categories and in the control group, but increased IgE levels (P < 0.01) and DTH skin test anergy (P < 0.006) were observed among acquired immunodeficiency syndrome (AIDS) patients. Conclusions The density of skin mast cells in HIV infection was not modified in the course of the disease. Mast cells do not seem to be primarily responsible for triggering hypersensitivity dermatoses among AIDS patients, although data in support of the Th2 response, as seen in increased IgE serum levels and DTH anergy, are present.
Mast cells in leprosy and leprosy reaction
Authors: Mahaisavariya Punkae , Jiamton Sukhum , Manonukul Jane , Khemngern Supakan 
Published: March 2003

AbstractBackground Mast cells can be visualized in routine, acid‐fast‐staining, paraffin tissue section as metachromatic staining cells, and can be activated to release inflammatory mediators which play a role in the cell‐mediated immune response. Methods Skin biopsy tissues were taken from the most active skin lesion of each leprosy patient at the time of diagnosis (nonreactional group) and at the time of reaction (reactional group) during the years 1994–1997 in the leprosy clinic at the Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. Mast cells were identified by metachromatic staining (purple) in Fite's stain sections and reported as the average number of cells per high power field in three compartments: at the center and periphery of the granuloma and in the interstitium. The data were analyzed in three groups: nonreactional group, type I, and type II leprosy reactions. The mast cell count of each group and each compartment of the section, expressed as the mean ± standard error, was compared. Results A total of 95 persons were included in the study, but 108 tissue sections were obtained due to nine cases having more than one section. Of these patients, 63 cases (66.32%) had no reaction, 19 cases (20%) had type I reaction, and 13 cases had type II reaction. There was no difference in age and sex among these groups. The mast cell count in the interstitium was higher than that within the granuloma, both at the center and at the periphery, in every type, and the count in this area reduced significantly in leprosy reactions, both type I and type II, compared with the nonreactional group. Conclusions The change in the average mast cell number in nonreactional leprosy and leprosy reactions may indicate the important role of mast cells in dynamic changes in the cell‐mediated immune response in leprosy and leprosy reactions.
Smoldering HTLV‐1‐induced T‐cell lymphoma localized within the skin; a radiation‐resistant tumor
Authors: Germain Marguerite , Williams John , Skelton Henry G. , Smith Kathleen J. 
Published: March 2003

AbstractBackground  Human T‐cell lymphotrophic virus type 1 (HTLV‐1)‐induced lymphoproliferative disease occurs in approximately 3–5% of people in endemic areas who have been HTLV‐1 positive for decades. Lymphoproliferative disease may present as four subtypes, including an acute adult T‐cell leukemia/lymphoma (ATLL), an aggressive HTLV‐1 lymphoma, chronic ATLL, and smoldering ATLL.Materials and methods  A 72‐year‐old HTLV‐1+ Haitian woman presented with a 2‐year history of a cutaneous eruption localized to the right arm. The eruption had evolved into multinodular lesions over the past 6–7 months. Peripheral blood and cutaneous biopsy specimens were evaluated. Immunohistochemical studies for lymphoid markers were performed on the cutaneous biopsy material, and polymerase chain reaction (PCR) and Southern blot assay were evaluated for the presence and integration of HTLV‐1 within the genome.Results  The biopsy specimen showed a pleomorphic T‐cell infiltrate with epidermotrophism, and an immunohistochemical phenotype showing CD3+, CD4+, CD8–, CD25, CD30–, HLDA‐DR+ cells. PCR and Southern blot assay evaluation showed a single clonal integration of HTLV‐1 provirus within a monoclonal tumor cell population. The patient had no abnormal lymphoid forms on peripheral smear at presentation, and no evidence of other organ involvement.Conclusions  Smoldering HTLV‐1‐induced lymphoma is uncommon even in endemic areas. In previously reported cases, the smoldering variant was accompanied by abnormal forms in the peripheral blood and/or by other signs of systemic disease. This case illustrates that smoldering disease may be localized to the skin with no detected morphologic abnormalities on peripheral smear.
Dendritic epidermal γ/δ T cells (DETC) activated in vivo proliferate in vitro in response to Mycobacterium leprae antigens
Authors: Kaminski Marek J. , Mroczkowski Tomasz F. , Krotoski Wojciech A 
Published: March 2003

Abstract Background  γ
/
δ T‐cell receptor (TCR)+ dendritic epidermal T cells (DETC) are part of a primitive defense system in the skin; they are capable of responding only to a limited number of antigens. The aim of the present study was to test whether DETC can proliferate in vitro in response to antigens of Mycobacterium leprae.Methods  DETC were obtained from CBA mouse ear skin by trypsinization and Histopaque gradient centrifugation. The resulting epidermal cell suspension contained up to 20% DETC, as analyzed by the fluorescence activated cell sorter (FACS) after staining with anti‐Thy‐1 or anti‐γ/δ TCR monoclonal antibodies (mAbs). The freshly isolated cells, or DETC cultured up to 4 weeks with interleukin‐2 (IL‐2), were exposed in vitro for up to 6 days to varying doses of the following M. leprae antigens: (1) integral (live) M. leprae bacilli; (2) Dharmendra antigen; and (3) PGL‐1 (phenolic glycolipid of M. leprae). The DETC response was assessed by tritiated thymidine (3H‐TdR) incorporation.Results  The freshly isolated DETC, or DETC cultured up to 4 weeks with IL‐2, did not respond significantly to any of the M. leprae antigens, although at the same time they were able to respond vigorously to concanavalin A (Con A), as positive control. If, however, DETC were isolated from skin, painted 7 days before with croton oil (10 μL/cm2 to cause irritant dermatitis, they were able to respond to all M. leprae antigens by a 3–4‐fold incrase in the 3H‐TdR uptake. The most effective stimulator was a 1 : 1 mixture of Dharmendra and PGL‐1 (0.01 μg/mL), which was as effective as 10‐fold higher doses of either antigen alone. Cell counts confirmed that increased DNA synthesis was associated with cell proliferation. Experiments employing α/β‐TCR CBA murine spleen cells and epidermal cell suspension treated with anti‐γ/δ or antiα/β mAbs + C′ proved that only the γ/δ DETC were the responder cells to M. leprae antigens.Conclusions  The results suggest that activation of DETC in vivo may make them responsive to M. leprae antigens. A significant increase in the number of class II major histocompatibility complex (MHC) positive, nondendritic cells was observed in the croton oil‐treated epidermis. We hypothesize that croson oil‐induced upregulation of class II MHC expression, which endows epidermal cells with antigen‐presenting capabilities, might be an important factor in vivo in delivering an immunogenic signal to resident DETC in the skin.