bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erythema induratum of bazin: role of polymerase chain reaction in diagnosis
Authors: Jacinto Sylvia S. , Nograles Kristine B. 
Published: May 2003

A 55‐year‐old man presented with recurrent multiple ulcerative nodules and plaques of 1‐year duration over the lower extremities. They were recalcitrant to topical (hydrocortisone cream) and systemic (pentoxyfylline, cefotiam) drugs. Skin surface examination of the affected areas showed the skin to be studded with violaceous nodules and/or plaques. A few of these had draining ulcers. The nature of the fluid was serosanguous. The lesions were located on the shins of the legs (Fig. 1). They were bilateral and asymmetrical. In addition, nontender, erythematous nodules of annular configuration were located on the right knee and elbow, and a few toes. The arterial pulsation was within normal limits. Serial hematoxylin‐eosin stained sections prepared from a representative lesion were marked by the presence of palisading granulomatous dermatitis (Fig. 2). A granulomatous folluculitis in the deep dermis and a thrombotic arteriole in the subcutis were also found. Sections counter‐stained for the presence of acid‐fast bacilli were negative. Paraffin‐embedded biopsy specimens were subjected to DNA analysis using the IS6110 gene as a polymerase chain reaction (PCR) primer, and were found to be positive. Serial chest X‐rays taken at an interval of 4 months showed findings indicative of active pulmonary tuberculosis. Anti‐tubercular therapy (ATT) comprising 450 mg of rifampicin, 300 mg of isoniazid, 800 mg of pyrazinamide and 1500 mg of ethambutol was administered for a period of 2 months followed by 450 mg of rifampicin and 300 mg of isoniazid for another 2 months. There was perceptible healing of the lesions, leaving atrophic and hyperpigmented scars.Multiple, violaceous, ulcerated plaques and nodules on the shins of both legsimagePalisading granuloma (H&E, × 50)image
The use of the freer dissector for the removal of trichilemmal cysts
Authors: Ikizoglu Guliz , Kaya Tamer Irfan , Tursen Umit , Baz Kiymet 
Published: May 2003

AbstractBackground Trichilemmal cysts are keratin‐containing cysts, usually situated on the scalp. They often show an autosomal dominant inheritance pattern. Excision is the treatment of choice. We describe a practical surgical technique that eases the removal of these cysts.Methods A 24‐year‐old woman presented with a 5‐year history of cystic lesions on her scalp, clinically diagnosed as trichilemmal cysts. She was treated with the new technique. After making a small incision under local anesthesia, a freer dissector (Aesculap® OL 165 R) was used as a blunt dissector. The freer dissector was inserted through the incision. A blunt dissection was made to dissect the cyst free from the surrounding dermis and, by using the dissector as a lever, gentle pressure was applied to the opposite side to ease the cyst from the dermis. Four cysts were removed with this technique.Results The treatment was well tolerated by the patient. No complications developed during or after the procedure.Conclusions This modified technique is simple and practical. The slight curve at each end of the freer dissector makes it easy to grasp the cyst and, functioning like forceps, the cyst can be eased from the dermis. We believe that the use of the freer dissector in the surgical excision of trichilemmal cysts aids and speeds up the procedure.
Treatment of chromomycosis by cryosurgery with liquid nitrogen: 15 years’ experience
Authors: Castro Luiz G. M. , Pimentel Eugênio R. A. , Lacaz Carlos S. 
Published: May 2003

AbstractBackground Chromomycosis is a chronic fungal infection of the skin and subcutaneous tissue caused by various dematiaceous fungi, the most common of which is Fonsecaea pedrosoi. The disease is difficult to treat.Methods Twenty‐two chromomycosis patients treated by cryosurgery with liquid nitrogen as the sole or associated therapy were studied. Diagnosis was confirmed by direct examination of KOH cleared specimens, culture, and histology, according to a method previously described by Pimentel et al. (Pimentel ERA, Castro LGM, Cucé LC, Sampaio SAP. Treatment of chromomycosis by cryosurgery with liquid nitrogen. J Dermatol Surg Oncol 1989; 15: 72–77). Small lesions were frozen in a single session, whilst larger lesions were frozen in small parts. All patients received double freeze–thaw cycles. An author‐created severity index, based on the extent of the diseased area, number of lesions, presence of complications (lymphedema, ulceration, and secondary infection) and unresponsiveness to previous treatments, was used to determine disease severity.Results Fonsecaea pedrosoi was isolated from all but one patient. Caucasian (50.0%) males (4.5 : 1.0) were most commonly affected. The average number of cryosurgery sessions per patient was 6.7, varying from one to 22 sessions. The duration of treatment lasted for up to 126 months. Nine patients (40.9%) were considered to be cured (clinically disease‐free period of at least 3 years), eight (36.4%) were under observation (clinically disease‐free but less than 3 years of follow‐up), two (9.1%) were under treatment (still with active lesions), and three (13.6%) were classified as unsuccessful. The average cure period was 7.5 years, varying from 3 to 16 years. Five (55.6%) of the nine cured patients had been cured for periods exceeding 9 years. Six (66.7%) of the nine cured patients were classified as having mild, two (22.2%) severe, and one (11.1%) moderate disease.Conclusions Cryosurgery with liquid nitrogen is an option in the treatment of chromomycosis.
Increased hydrogen peroxide generation by neutrophils from patients with acne inflammation
Authors: Akamatsu Hirohiko , Horio Takeshi , Hattori Kazuhiro 
Published: May 2003

AbstractBackground Reactive oxygen species generated by neutrophils are closely correlated with the pathogenesis of a variety of inflammatory skin diseases. The aim of this study was to investigate the possible role of reactive oxygen species generated by neutrophils in the mediation of acne inflammation.Methods Bacterial phagocytotic stimuli, mediated by opsonin activity, were applied to whole blood, and neutrophil hydrogen peroxide production was measured.Results Patients with acne inflammation showed a significantly increased level of hydrogen peroxide produced by neutrophils compared to patients with acne comedones and healthy controls. There were no marked differences in the level of hydrogen peroxide produced by neutrophils between patients with acne comedones and healthy controls. In addition, patients with acne inflammation treated by oral administration of minocycline hydrochloride, a drug that inhibits hydrogen peroxide generation by neutrophils, showed a significant decrease in the ability of neutrophils to produce hydrogen peroxide in accordance with a decrease in the inflammatory activity of acne lesions.Conclusions The present study seems to suggest that acne inflammation is mediated in part by hydrogen peroxide generation by neutrophils.
Achievements of dermatological research in Denmark and Israel: a comparative 10‐year study
Authors: Enk Claes D. , Levy Louis 
Published: May 2003

AbstractWide differences of achievement in dermatological research between Denmark and Israel have been reported, although the two countries are comparable in terms of academic dermatological structure. The aims of the present study were to document these differences by means of bibliometric analysis, and to attempt to elucidate the causes of these differences. Employing MEDLINE searches for the 10‐year period 1988–97, quantitative and qualitative comparisons of the dermatological publications from these two countries were conducted. We found the achievements of Danish dermatological research to be superior to those of Israel, and suggest that the large proportion of case reports and reviews is one cause of the relatively low ranking of Israeli dermatological research efforts.
Churg–Strauss syndrome manifested by urticarial plaques
Authors: Tlacuilo‐Parra Alberto , Soto‐Ortíz José Alfredo , Guevara‐Gutiérrez Elizabeth 
Published: May 2003

A 49‐year‐old mestizo Mexican woman, who had suffered with asthma for 30 years, presented with a 6‐week history of fever, hyaline rhinorrea, myalgias, and arthralgias, with thoracic pain in the right apical and retrosternal region and dyspnea with little effort, without response to antimicrobials or bronchodilators. Four weeks previously, she had developed three painful urticarial plaques on the right thigh and genital region, accompanied by paresthesia in the same extremity. These correlated with the remission of asthma.Physical examination demonstrated three erythematous and edematous plaques, measuring from 1.5 cm to 20 cm, with ill‐defined borders (Fig. 1), on the inner side of the right thigh, inguinal and crural regions. Laboratory tests showed a hemoglobin level of 14 g/dL, a hematocrit of 44%, leukocytes of 8003/mm3, eosinophils of 2020/mm3 (25.2%), platelets of 244,000/mm3, an erythrocyte sedimentation rate of 80 mm/h, and immunoglobulin E (IgE) elevated to 224 U/mL. Urinalysis, complement, and antinuclear antibody tests were normal or negative. Chest roentgenogram showed a micronodular infiltrate in the right apex and inferior lobe; X‐rays of the paranasal sinuses were normal. A biopsy of the skin demonstrated an infiltration in the dermis with a predominance of eosinophils infiltrating the vascular walls (Fig. 2). There were no granulomas.Erythematous and edematous urticaria‐like plaques on the thighimagePerivascular infiltrate with predominantly eosinophils and lymphocytes with degenerated collagen fibersimageShe showed a good response to oral corticosteroids, with total remission of symptoms and normalization of the eosinophil count and IgE levels.
Sunscreen use and skin protection behavior on the Belgian beach
Authors: Devos Steven A. , Baeyens Katrien , Van Hecke Lien 
Published: May 2003

AbstractBackground Public health campaigns encourage the public to protect themselves against skin cancer by using sunscreens and taking other protective measures. However, it is difficult to estimate the level of awareness among the general public.Methods This study explores the prevalence and predictors of solar protection behavior in a community sample of beachgoers. During the months of May, June, July and August 2001 a total of 360 participants (145 men and 215 women) were randomly selected from several Belgian beaches in and around the city of Ostend, Belgium. The solar protection behavior of each participant was assessed by direct observation and interview.Results The risk awareness percentages were 70.6% for skin cancer, 60.8% for sunburn and 25.0% for skin aging. These percentages were considerably higher in the female participant group than in the male group. Sunscreen cream was the most popular preventive behavior, especially in the female population, whereas the alternative protective measures (limited exposure during peak sun hours, the use of shade and the use of protective clothing and hats) were more popular in the male group.Conclusions While solar protection has become part of routine beach behavior, there is room for improvement by more frequent application of sunscreen cream, the use of a higher sun protection factor (SPF) (15+), timed sunbathing, more use of clothing and hats and more seeking of shade. The results of this study can assist in evaluating the effectiveness of current sun‐protection campaigns and health education programs.
Ultraviolet radiation properties as applied to photoclimatherapy at the Dead Sea
Authors: Kudish A. I. , Abels D. , Harari M. 
Published: May 2003

AbstractBackground The Dead Sea basin, the lowest terrestrial point on earth, is recognized as a natural treatment center for patients with various cutaneous and rheumatic diseases. Psoriasis is the major skin disease treated at the Dead Sea with excellent improvement to complete clearance exceeding 85% after 4 weeks of treatment. These results were postulated to be associated with a unique spectrum of ultraviolet radiation present in the Dead Sea area.Methods The UVB and UVA radiation at two sites is measured continuously by identical sets of broad‐band Solar Light Co. Inc. meters (Philadelphia, PA). The spectral selectivity within the UVB and UVA spectrum was determined using a narrow‐band spectroradiometer, UV‐Optronics 742 (Orlando, FL). The optimum exposure time intervals for photoclimatherapy, defined as the minimum ratio of erythema to therapeutic radiation intensities, were also determined using a Solar Light Co. Inc. Microtops II, Ozone Monitor‐Sunphotometer.Results The ultraviolet radiation at the Dead Sea is attenuated relative to Beer Sheva as a result of the increased optical path length and consequent enhanced scattering. The UVB radiation is attenuated to a greater extent than UVA and the shorter erythema UVB spectral range decreased significantly compared with the longer therapeutic UVB wavelengths.Conclusions It was demonstrated that the relative attenuation within the UVB spectral range is greatest for the shorter erythema rays and less for the longer therapeutic UVB wavelengths, thus producing a greater proportion of the longer therapeutic UVB wavelengths in the ultraviolet spectrum. These measurements can be utilized to minimize the exposure to solar radiation by correlating the cumulative UVB radiation dose to treatment efficacy and by formulating a patient sun exposure treatment protocol for Dead Sea photoclimatherapy.
Lichen planopilaris: report of 30 cases and review of the literature
Authors: Chieregato C. , Zini A. , Barba A. , Magnanini M. , Rosina P. 
Published: May 2003

AbstractBackground Lichen planopilaris (LPP) affects primarily the scalp, resulting in scaling, atrophy, and alopecia with scarring. The purpose of our study was to obtain original data on LPP and to evaluate the efficacy of topical therapy in comparison with systemic therapies.Methods We examined 30 patients affected by LPP between 1996 and 2001, performing clinical, laboratory, histopathologic and direct immunofluorescence examinations. Twenty‐one of the patients (70%) were women and nine (30%) were men. The average age at presentation was 51.5 years. The average duration of the disease was 13 months at the time of the diagnosis. All patients received topical steroids for a total of 12 weeks.Results Resolution of the inflammatory process and blocking of the cicatricial progression were observed in 66% of cases, a mild reduction of fibrosis and cicatrization in 20% of patients, and no response in 13%.Conclusions We concluded that topical therapy may be a valid alternative to systemic therapies, especially in patients with lesions in the early phase.
Axillary intertriginous granular parakeratosis responsive to topical calcipotriene and ammonium lactate
Authors: Contreras Michael E. , Gottfried Lisa C. , Bang Ran H. , Palmer Charles H. 
Published: May 2003

A 70‐year‐old white man presented to our clinic with a 6–8‐month history of a pruritic, occasionally burning eruption in both axillae. He had been using the same deodorant for more than 1 year and denied any changes in laundry detergent, soaps, or shampoos. He also denied application of other topical products. On physical examination, there were slightly erythematous, lichenified plaques in both axillae, with more extensive involvement of the left side (Fig. 1). Histologic examination of a punch biopsy specimen from a left axillary plaque revealed hyperkeratosis with retention of nuclei and keratohyaline granules in the stratum corneum (Fig. 2). The stratum granulosum was slightly thickened, and the epidermis was mildly acanthotic. Patch tests of the patient's deodorant and shampoo were negative. The patient was advised to discontinue use of his deodorant. His right axilla was treated with topical calcipotriene, applied twice daily, and his left axilla was treated with topical 12% ammonium lactate, applied twice daily. One month later, the lesions in the right axilla had completely resolved. The left axilla was slightly improved, but still exhibited dusky erythematous plaques. After one additional month of treatment with ammonium lactate, the left axillary lesions completely resolved. A follow‐up examination 9 months later revealed no recurrence of the lesions in either axilla.Erythematous, lichenified plaques in the axillaimagePhotomicrograph of biopsy specimen showing keratohyaline granules in the stratum corneum (hematoxylin and eosin, × 200)image
Bromoderma
Authors: Anzai Saburo , Fujiwara Sakuhei , Inuzuka Miki 
Published: May 2003

A 3‐year‐old Japanese girl with severe epilepsy had been treated with potassium bromide since August 1999. The dose of potassium bromide was increased from 0.5 g/day to 0.8 g/day in May 2000 because of poor control of epilepsy. She also presented high fever, caused by bacterial pneumonia, in the same period. On June 11, a reddish eruption suddenly appeared on her back. Physical examination revealed grain‐size, dark‐red, erythematous papules and pustules on the back and face (Fig. 1). Some of the lesions on the back were ovoid to circular with small pustules and necrotic centers. Although some papules seemed to have dell in their centers, showing the appearance of herpes virus infection, Tzanck test was negative. A biopsy specimen obtained from one of the papules revealed a massive infiltration of eosinophils and neutrophils, forming an abscess in the epidermis and dermis (Fig. 2). The serum bromide level, which was 43.7 mEq/L (normal, 0–5 mEq/L) on May 25, increased to 114 mEq/L on June 14. The eruption disappeared within 10 days after the withdrawal of potassium bromide and treatment with topical sulfadiazine silver cream. The serum bromide decreased to 56.8 mEq/L on July 6.Multiple papules and pustules on the backimageIntraepidermal and intradermal abscess (hematoxylin and eosin stain, × 100)image
Evaluation of clinical findings according to sex in 2313 Turkish patients with Behçet's disease
Authors: Tursen Umit , Gurler Aysel , Boyvat Ayse 
Published: May 2003

AbstractBackground Behçet's disease is a multisystem disease featuring mucocutaneous, ocular, articular, vascular, intestinal, urogenital, and neurologic involvement and occurs with a high prevalence in the Mediterranean including Turkey. Higher incidence of severe clinical course and systemic involvement is observed in male patients.Objective To determine the influence of sex on the clinical course of Behçet’ s disease.Methods We retrospectively evaluated the clinical findings of 2313 Behçet patients followed up at the multidisciplinary Behçet's Disease Center at Ankara University.Results The male/female patient ratio was 1.03. Oral aphthae was seen in all patients. In male Behçet patients, the prevalence of mucocutaneous lesions and systemic manifestations was as follows: 85.6% genital aphthae, 45.5% erythema nodosum, 59.5% papulopustular lesions, 17.5% thrombophlebitis, 38.1% ocular involvement, 11.3% articular involvement, 11.7% vascular involvement, 3.3% neurologic involvement, 1.4% gastrointestinal involvement, and 1.8% pulmonary involvement. In female Behçet patients, the prevalence of manifestations were as follows: 91% genital aphthae, 49.8% erythema nodosum, 48.3% papulopustular lesions, 3.5% thrombophlebitis, 19.8% ocular involvement, 11.8% articular involvement, 2.1% vascular involvement, 1.3% neurologic involvement, 1.4% gastrointestinal involvement, and 0.03% pulmonary involvement.Conclusions Only genital aphthae and erythema nodosum were more frequent in females. On the other hand papulopustular eruptions, thrombophlebitis, ocular, neurologic, pulmonary and vascular involvement were more frequent in males. While female patients had the best prognosis, male patients had a worse overall prognosis than females.
Ulcers caused by bullous morphea treated with tissue‐engineered skin
Authors: Martin Lucy K. , Kirsner Robert S. 
Published: May 2003

AbstractBullous morphea is an uncommon form of localized scleroderma. The exact pathogenesis is unknown and treatment of the accompanying ulcers is problematic. We report a patient with bullous morphea with long‐standing ulcers whom we successfully treated with the tissue‐engineered skin Apligraf (Organogenesis Inc., Canton, MA). The patient experienced rapid improvement in granulation tissue and the ulcers healed 4 months after a single application. The rationale for the use of Apligraf is based on experience with patients with venous ulcers who have surrounding peri‐ulcer fibrosis. This condition, termed lipodermatosclerosis, has been reported as a poor prognostic factor for healing, yet many ulcers associated with lipodermatosclerosis may respond to treatment with tissue‐engineered skin. Taken in concert, these results suggest a role for tissue‐ engineered skin in the treatment of chronic wounds with surrounding fibrosis.
Recurrent aphthous stomatitis unresponsive to topical corticosteroids: a study of the comparative therapeutic effects of systemic prednisone and systemic sulodexide
Authors: Femiano Felice , Gombos Fernando , Scully Crispian 
Published: May 2003

AbstractBackground Recurrent aphthous stomatitis (RAS) is a common oral condition, the etiology of which remains largely unclear. Numerous therapeutic protocols have been tried. Apart from immunomodulators, no therapy is unequivocally effective, and many systemic therapies have potential adverse effects.Objective To compare, in patients with frequent RAS unresponsive to conventional therapies, the therapeutic effectiveness of systemic prednisone with that of systemic sulodexide, a low‐molecular‐weight heparin with immunosuppressive activity but few adverse effects.Methods The study involved a group of 30 patients suffering from frequent minor RAS over ≥ 4 months unresponsive to topical corticosteroids. Patients were randomly assigned to one of three study groups: blind therapy with systemic sulodexide or systemic prednisone and control (no treatment). The outcomes were assessed blind on the basis of the days to recovery from pain and days to recovery from ulceration (epithelialization) during the first month of therapy; the number of aphthae appearing during the second month of therapy; and the number of aphthae appearing in the 2 months after the end of the 2‐month treatment cycle.Results and conclusions The effectiveness of systemic sulodexide was almost comparable with that of systemic prednisone in patients with frequent RAS, without significant adverse effects.
Quality assessment of seven types of fresh‐frozen plasma leucoreduced by specific plasma filtration
Authors: Chabanel A. , Sensebé I. , Masse M. , Maurel J. P. , Plante J. , Hivet D. , Kannengiesser C. , Naegelen C. , Joussemet M. , Marchesseau B. , Rasongles P. , Proust F. , David C. , Montembault A. M. , Bergeat P. 
Published: May 2003

Background and Objectives A study was undertaken to determine plasma quality after specific filtration.Materials and Methods Seven types of plasma were tested, after filtration of plasma from filtered or non‐filtered whole blood. Leucocyte counting was carried out after a 30‐fold concentration of the sample. Twenty‐nine parameters (including coagulation testing, proteins, coagulation factors and activation markers) were measured before and after filtration, and after 6 months of storage.Results After specific plasma filtration, the average residual leucocyte counts were less than 2250/l. In spite of small statistically significant changes in proteins, coagulation factors and complement activation, this study showed that plasma filtration did not alter plasma quality. After 6 months of storage at −30 °C, factor VIII recovery varied between 91 and 109%. Haemostasis parameters and activation markers remained within the normal range.Conclusions Specific plasma filtration reduced the leucocyte number to < 104 leucocytes/l. The quality of plasma was not altered by the additional step of specific plasma filtration.