bluuebunny/crossref_metadata_2025_split huggingface dataset:
Keratoacanthoma with perineural invasion: A report of 40 cases
Authors: Godbolt Amanda M , Sullivan John J , Weedon David 
Published: March 2003

SUMMARYKeratoacanthoma is a unique clinicopathological entity, despite a recent trend to regard it as a variant of squamous cell carcinoma. The occurrence of perineural invasion is an uncommon phenomenon in keratoacanthomas, with a predilection for lesions on the face. We studied a series of 40 cases of keratoacanthoma in which perineural invasion occurred. Of the 40 cases, 27 were from the head or neck region. We found no metastasis or direct death attributable to the presence of perineural invasion in the 35 cases in our series for whom follow‐up data were available. In only one case did local recurrence occur and this was not considered by the authors to be directly attributable to the presence of perineural invasion. These findings add further support to the notion that keratoacanthoma is biologically different from squamous cell carcinoma.
Comparative study of pemphigus vulgaris and pemphigus foliaceus in Singapore
Authors: Goon Anthony Teik‐Jin , Tan Suat‐Hoon 
Published: March 2003

SUMMARYThis is a retrospective study of all patients diagnosed to have pemphigus in our centre over a 3 year period. The case records of all patients with pemphigus from January 1995 to December 1997 were analysed. Fifty patients were diagnosed to have pemphigus during the study period. The diagnoses were pemphigus vulgaris in 31 patients, pemphigus foliaceus in 16, paraneoplastic pemphigus in two and IgA pemphigus in one. The average titre of anti‐intercellular antibodies in patients with pemphigus vulgaris (1:96) was higher than the titre in patients with pemphigus foliaceus (1:69). The average initial dose of prednisolone required for disease control in patients with pemphigus vulgaris (62 mg/day) was significantly higher than that required for patients with pemphigus foliaceus (44 mg/day). In our study population, pemphigus vulgaris is a more severe and chronic disease than pemphigus foliaceus, as reflected in the higher titre of anti‐intercellular antibodies, higher dose of systemic corticosteroids required for control of the disease, the longer duration to achieve complete remission and longer follow‐up period.
Neutrophilic fixed drug eruption
Authors: Agnew Karen L , Oliver G Fergus 
Published: March 2003

SUMMARYA 49‐year‐old man presented with a reproducible, localized amoxycillin–clavulanic acid‐induced eruption. The histopathology from lesional skin revealed a neutrophilic dermatosis. These histological findings have not been reported in previous fixed drug eruptions. A brief review is undertaken comparing fixed drug eruption and the group of neutrophilic dermatoses with our case presentation. We propose a new entity of neutrophilic fixed drug eruption.
Subcutaneous fat necrosis of the newborn following hypothermia and complicated by pain and hypercalcaemia
Authors: Wiadrowski Todd P , Marshman Gillian 
Published: March 2003

SUMMARYA female infant was delivered at term with complications of severe meconium aspiration and birth asphyxia. Surface cooling was performed in the first 24 hours as part of the management of her birth asphyxia. Woody erythema was noted at 24 hours, followed by the formation of red–purple nodules on the 6th day. Clinical findings in the first 24 hours were suggestive of cold panniculitis. However, clinical and histological findings progressed to be in keeping with the diagnosis of subcutaneous fat necrosis of the newborn (SCFN). Furthermore, the immediate postnatal period was complicated by pain resistant to treatment with opiates. Asymptomatic hypercalcaemia was noted on periodic testing at 7 weeks and treated by rehydration, diuretics, prednisolone, etidronate and a low‐calcium and ‐vitamin D diet. A review of the clinical and histological findings of the relevant panniculitides occurring in the postnatal period is presented, as well as a review of the treatment of hypercalcaemia in SCFN.
Vulval disease in pre‐pubertal girls
Authors: Fischer Gayle O 
Published: March 2003

SUMMARYChildren present with vulval complaints less frequently than do adults; although there are many similarities between paediatric and adult groups of patients with vulval disease, there are also important differences. In both groups, dermatitis, psoriasis and lichen sclerosus are the most frequently seen dermatoses. Birthmarks and congenital abnormalities presenting for the first time are more of an issue in children than in adults. Fusion of the labia and streptococcal vulvovaginitis are conditions seen only in the paediatric group. Sexually transmitted diseases such as genital warts and genital herpes are not common in this group and should always raise the possibility of child sexual abuse. Chronic vulvovaginal candidiasis, although a very common problem in adult patients, is not seen in the prepubertal group.
Accuracy and reliability of store‐and‐forward teledermatology: Preliminary results from the St George Teledermatology Project
Authors: Lim Adrian C , Egerton Ian B , See Adrian , Shumack Stephen P 
Published: March 2003

SUMMARYTeledermatology is the practice of dermatology across distances (and time) and involves the transfer of electronic information. To be effective and safe, the teledermatology process needs to demonstrate an acceptable level of accuracy and reliability. Accuracy is reflected by the degree of concordance (agreement) between the teledermatology and face‐to‐face diagnoses. Reliability is dependent on how consistently a set of results can be reproduced across different operators. Mean concordance (primary diagnoses) achieved by four dermatologists studying 53 store‐and‐forward diagnostic cases, originating from 49 referred patients, was 79% (range 73–85%). When the differential diagnoses were taken into account, the variation across individual dermatologists narrowed further, with a mean of 86% (range 83–89%). In contrast, the mean general practitioner (GP; n = 11) concordance (GP face‐to‐face vs reference dermatologist store‐and‐forward diagnoses) was 49%. An interim review of all 49 teledermatology patients showed no adverse outcome at the end of 3 months. The ability to request face‐to‐face visits by dermatologists, combined with GPs maintaining primary care of the referred patient, serve as additional safeguards for patients using a telemedicine system. Our results indicate that teledermatology management of referred skin complaints is both accurate and reliable.
Collarette scaling in pityriasis rosea demonstrated by digital epiluminescence dermatoscopy
Authors: Chuh Antonio AT 
Published: March 2003

SUMMARYCollarette scaling is a characteristic sign in pityriasis rosea. The use of digital epiluminescence dermatoscopy is proposed to assist in the recognition of this sign as this technique can magnify the lesions, eliminate other epidermal changes, and demonstrate the morphology and direction of scaling.
Review of neurological manifestations in 196 patients with sebaceous naevi
Authors: Davies Derek , Rogers Maureen 
Published: March 2003

SUMMARYThe incidence of neurological abnormalities in patients with sebaceous naevi may not be as high as has been previously accepted. One hundred and ninety‐six patients with epidermal naevi of the sebaceous type were examined for clinical neurological abnormalities. Ninety‐three per cent of these patients were neurologically normal on examination. Extensive naevi were present in 21% (3/14) of patients with neurological abnormalities and in 5% (9/182) of those without. A centrofacial location of the naevus was found in 21% (3/14) of patients with abnormalities and in 2% (4/182) of neurologically normal patients. A surprising finding was the low yield of abnormalities from neuroimaging in the patients with clinical neurological abnormalities. Imaging was performed in eight of the 14 and was normal in six patients. Despite the lower than expected rate of associated abnormalities and the low yield of abnormal findings from imaging, it is strongly recommended that all patients with sebaceous naevi have a detailed neurological assessment and that imaging be performed on all those in whom clinical abnormalities are demonstrated, as well as on those patients with large naevi involving the centrofacial area.
A granuloma annulare‐like eruption associated with the use of amlodipine
Authors: Lim Adrian C , Hart Kim , Murrell Dédée 
Published: March 2003

SUMMARYA granuloma annulare‐like drug reaction is a rarely encountered clinical entity. A 64‐year‐old Caucasian female developed a granuloma annulare‐like reaction 13 days after starting amlodipine and cleared within 3 months after drug cessation. The eruption consisted of multiple erythematous pruritic papules, distributed symmetrically over the lateral aspects of the legs and thighs, as well as on both palms. Histology showed focal collagen degeneration and significant interstitial histiocytic dermal infiltrate suggestive of granuloma annulare. We review previously reported cases of granuloma annulare‐like drug reactions, in the context of a recently proposed classification for drug‐induced interstitial granulomatous reactions.
Epidermolysis bullosa simplex Dowling–Meara due to an arginine to cysteine substitution in exon 1 of keratin 14
Authors: Premaratne Champi , Klingberg Sandra , Glass Ian , Wright Kellie , Murrell Dédée 
Published: March 2003

SUMMARYEpidermolysis bullosa simplex (EBS) is a blistering disorder affecting the basal layer of the epidermis usually inherited in an autosomal dominant fashion. Most cases are caused by mutations in the genes encoding keratin 5 (K5) and keratin 14 (K14) and are characterized by cytolysis within the basal layer of the epidermis. We report a patient manifesting the Dowling–Meara variant of EBS in whom we characterized a cytosine to thymine transition at codon 125 (R125C) in K14. This missense mutation is located at the amino terminus of the helical rod domain of the keratin 14 molecule, resulting in defective pairing with K5, thereby disrupting keratin tonofibril integrity.
Two unusual cases of toxic epidermal necrolysis
Authors: Yung Anthony , Agnew Karen , Snow John , Oliver Fergus 
Published: March 2003

SUMMARYTwo cases of toxic epidermal necrolysis (TEN) are presented. A 27‐year‐old woman presented with peripherally located targetoid plaques, papules, blisters and lip erosions which began 9 days after ‘recreational’ use of ‘speed’ (dexamphetamine and ephedrine) consistent with erythema multiforme major. Three days later she developed widespread lesions with large areas of blistering affecting 40% of body surface area. The diagnosis was revised to TEN. Intravenous cyclosporin led to rapid prevention of new blister formation. A 71‐year‐old woman, 3 months after commencing amiodarone, developed extensive erythema, blistering and erosions affecting 50% of body surface area, with a maculopapular rash affecting the limbs and extremities consistent with a diagnosis of TEN. She developed septicaemia following bilateral pneumonia with pleural effusions and died 7 days after admission.
Primary cutaneous zygomycosis due to Mucor circinelloides
Authors: Chandra Suresh , Woodgyer Alan 
Published: March 2003

SUMMARYA 62‐year‐old woman with myelodysplastic syndrome presented with a 4‐week history of a large indurated ulcer with a black eschar on the forearm following trauma. On biopsy a diagnosis of zygomycosis was made as broad, sparsely septate, thin‐walled hyphae were seen in the deep dermis and subcutaneous fat. The zygomycete fungus Mucor circinelloides was cultured from tissue. Further investigation confirmed that the infection was localized to the skin. The 6 × 4 cm lesion was excised and the defect closed with a neurovascular island flap. No other treatment was undertaken. The patient died 6 months later from her haematological disease without recurrence of the fungal infection.
Multiple hereditary glomangiomas: Successful treatment with sclerotherapy
Authors: Parsi Kurosh , Kossard Steven 
Published: March 2003

SUMMARYGlomangiomas are characterized by cavernous vascular channels surrounded by glomus cells. Multiple glomangiomas, although usually painless, can be a few centimetres in size and appear as blue phlebectatic lesions. Surgical excision of multiple glomangiomas can lead to scarring and recurrences. Laser treatment using vascular lasers and CO2 lasers has been useful in small, superficial lesions. We present the successful sclerotherapy treatment of multiple glomangiomas using sodium tetradecyl sulphate in a 59‐year‐old man who presented with postoperative recurrence of multiple lesions.
Subacute cutaneous lupus erythematosus presenting in a child
Authors: Ciconte Antoinette , Mills Alan E , Shipley Andrew , Marks Robin 
Published: March 2003

SUMMARYA 5‐year‐old girl presented in summer with an erythematous, scaly annular eruption in a malar distribution. She had no symptoms or signs of systemic lupus erythematosus. A diagnosis of subacute cutaneous lupus erythematosus was made on the basis of the clinical and histological features, positive anti‐Ro antibody and a mildly elevated erythrocyte sedimentation rate. All other investigations, including complement studies, were normal. She has responded well to treatment with 0.5% alclometasone ointment and photoprotection.
Congenital annular erythema persisting in a 15‐year‐old girl
Authors: Wong Li‐Chuen , Kakakios Alyson , Rogers Maureen 
Published: March 2003

SUMMARYWe present a 15‐year‐old girl who has had a persisting extensive annular erythematous eruption since birth. Otherwise, she is healthy and developmentally normal. Multiple investigations throughout the years have been normal or negative. Numerous treatments have been tried, but with little success. Both clinical and histological examination fit no known classification. It is most consistent with annular erythema of infancy but could be the first reported case of a new entity. A review of other causes of annular erythema in infancy is presented.
Basal cell carcinoma of the lip treated with radiotherapy
Authors: Huynh Nghi T , Veness Michael J 
Published: March 2003

SUMMARYBasal cell carcinoma (BCC) of the lip is uncommon relative to other cutaneous sites for BCC, such as the central face or scalp. A female predisposition and predilection for the upper lip have been previously documented. A retrospective analysis of patients treated for BCC of the lip was undertaken within the department of Radiation Oncology, Westmead Hospital, Sydney. Twenty patients were identified; 12 women and 8 men. The majority (15/20) had T1 lesions of the upper lip (17/20). Eleven patients were referred for radiotherapy alone and nine for adjuvant radiotherapy following either incomplete excision or local recurrence. With a mean follow up of 36 months no patient has recurred following either definitive or adjuvant radiotherapy. Despite the majority of BCCs of the lip being amenable to surgery fractionated external beam radiotherapy remains an option especially when functional and/or cosmetic concerns are an issue. We present the findings from this small case series and use our findings to illustrate the role of radiotherapy in treating BCC of the lip.
Frontal fibrosing alopecia associated with cutaneous lichen planus in a premenopausal woman
Authors: Faulkner Catherine F , Wilson Niall J , Jones Stephen K 
Published: March 2003

SUMMARYA 45‐year‐old premenopausal woman presented with an 18‐month history of a band‐like area of fibrosing alopecia affecting the frontoparietal scalp. She also had marked thinning of the eyebrows. The histopathology was consistent with frontal fibrosing alopecia (FFA). Several months later she developed multiple pruritic papules on the wrists and feet. The clinical presentation and histopathology were consistent with cutaneous lichen planus. Although FFA has been reported to occur with mucosal lichen planus this is the first reported case of FFA associated with cutaneous lichen planus. This provides further evidence that FFA is a variant of lichen planopilaris.
Acral pityriasis lichenoides
Authors: Kossard Steven 
Published: March 2003

SUMMARYTwo patients presented with acrally located papulosquamous lesions that were polymorphic and had an identical morphology to those of pityriasis lichenoides. The lesions remained localized to the feet and ankles for years. Multiple skin biopsies had the histopathological features of pityriasis lichenoides. In one biopsy syringotropic lymphocytes and early syringolymphoid hyperplasia were observed.This rare variant of pityriasis lichenoides may be under‐recognized and misdiagnosed as it resembles a variety of papulosquamous disorders particularly psoriasis.
Idiopathic calciphylaxis
Authors: Banky Jeremy P , Dowling John P , Miles Campbell 
Published: March 2003

SUMMARYA 68‐year‐old woman presented with a painful necrotic ulcer on her right calf and necrotic breakdown of a left below‐knee amputation stump as a result of calciphylaxis. No cause could be identified and corrected. Treatment comprised wound care, substituting low molecular weight heparin for warfarin, hyperbaric oxygenation and etidronate disodium, none of which were helpful and major limb amputations were considered the best option for this patient.
Multicentric reticulohistiocytosis presenting with a rash and arthralgia
Authors: Hiramanek Navaz , Kossard Steven , Barnetson Ross StC 
Published: March 2003

SUMMARYA case of multicentric reticulohistiocytosis in a 53‐year‐old woman with a history of generalized cutaneous eruptions followed by arthralgia is presented. A thorough malignancy screen was performed with negative results. Treatment was commenced with oral prednisone 20 mg daily, which rapidly resulted in marked improvement of joint symptoms and resolution of self‐perceived functional disability. As there was little improvement of her rash, oral azathioprine was added at 100 mg daily. Both drugs were well‐tolerated and the patient was discharged from hospital on these medications. Two months later the azathioprine was reduced to 50 mg per day orally, following a small rise in hepatic transaminases. Within 4 months there had been dramatic improvement in the rash and cutaneous nodules with complete remission of the arthralgia and pruritus. During this time the oral prednisone had gradually been decreased to 10 mg daily. To date only the periungual nodules persist.
Survey of phototherapy practice by dermatologists in Australia
Authors: Huynh Nghi T , Sullivan John R , Commens Christopher A 
Published: March 2003

SUMMARYA postal survey was sent to all dermatologists in Australia to determine current phototherapy practices. Questionnaires were returned by 158 (57%) of 277 dermatologists, of whom 112 (71%) provided phototherapy. Large variations existed in attitudes and practice, including indications, contraindications, dosage schedules, equipment maintenance, response to adverse events, and follow‐up arrangements. Cumulative ultraviolet (UV) doses for psoralen and UVA (PUVA) were not calculated by 21%, while 30% did not calculate cumulative doses for UVB. Written informed consent was not obtained by 32%. Phototherapist dermatologists reported 25 patients developing melanoma following PUVA. Only 30% of Australian dermatologists organize regular follow up of patients after phototherapy.Australians have the highest rates of melanoma and non‐melanoma skin cancers in the world, because of their ancestry and high solar exposure. This makes it inappropriate for Australian dermatologists to rely entirely on foreign safety data when assessing the risks and benefits of phototherapy in Australian patients. There is a need for standardized Australian guidelines that can be prospectively assessed to ensure phototherapy is used to maximize efficacy and minimize risks in Australian patients, given their unique ancestral mix and outdoor lifestyle.
Fatal group A streptococcal necrotizing fasciitis and toxic shock syndrome in a patient with psoriasis and chronic renal impairment
Authors: Chong Alvin H , Burrows Nigel P 
Published: March 2003

SUMMARYA 78‐year‐old woman presented with rapid onset of skin pain which evolved into oedema, discoloration and infarction. She was diagnosed with group A β‐haemolytic streptococcus (Streptococcus pyogenes) necrotizing fasciitis and streptococcal toxic shock syndrome. The patient had a past history of psoriasis and end‐stage renal impairment. Despite treatment with multiple antibiotics in an intensive care unit, the skin infarction involving the upper trunk continued to expand and the patient died within 24 hours of hospital admission. Group A streptococcus and Staphylococcus aureus were cultured from a tissue biopsy. Renal failure and compromised skin barrier function are known to predispose to invasive streptococcal infections, but necrotizing fasciitis has only rarely been reported in association with psoriasis. This case illustrates the fulminant nature of the infection.
Staphylococcal scalded skin syndrome complicating acute generalized pustular psoriasis
Authors: Sharkey Michael P , Muir James B 
Published: March 2003

SUMMARYA 60‐year‐old woman with psoriasis vulgaris treated with oral cyclosporin and acitretin developed an acute generalized pustular eruption with erythema and associated fever consistent with acute generalized pustular psoriasis. She was admitted to hospital and, despite intravenous fluid replacement, developed acute renal failure. In addition, she developed staphylococcal septicaemia. After transfer to the intensive care unit because of deteriorating renal function, a sudden onset of widespread flaccid blistering (Nikolsky sign positive) and superficial erosions was noted. Histology of a biopsied blister revealed subcorneal splitting of the epidermis consistent with staphylococcal scalded skin syndrome. The patient was treated with intravenous dicloxacillin and the blistering gradually improved over 10 days.
Late‐onset warfarin necrosis
Authors: Scarff Catherine E , Baker Chris , Hill Prue , Foley Peter 
Published: March 2003

SUMMARYA 43‐year‐old woman developed tenderness and induration of her thighs and lower abdomen, 56 days after commencing warfarin for aortic and mitral valve replacements. Investigations showed elevated inflammatory markers, mild renal impairment, normal echocardiogram and low protein C and S levels consistent with warfarin therapy. Three weeks later, purpuric areas evolved into large tender haemoserous bullae, which broke down to form ulcers. Histology confirmed the clinical impression of warfarin‐induced skin necrosis with dermal and subcutaneous venular thrombi. Despite cessation of warfarin and commencement of heparin, the lesions progressed. When the patient became febrile, blood cultures grew Pseudomonas aeruginosa, which was treated with intravenous imipenem and vancomycin. Wound swabs grew methycillin‐resistant Staphylococcus aureus and the antibiotics were changed. The patient developed septic shock and, despite intensive care management, her condition deteriorated and she died 9 weeks after the onset of the skin symptoms.
Allergic contact dermatitis following exposure to essential oils
Authors: Bleasel Narelle , Tate Bruce , Rademaker Marius 
Published: March 2003

SUMMARYAllergic contact dermatitis from the topical use of essential oils is not widely recognized as an occupational hazard. Four cases of allergic contact dermatitis to essential oils occurring in three aromatherapists and one chemist with a particular interest in aromatherapy are described. All presented with predominantly hand dermatitis and demonstrated sensitization to multiple essential oils. One patient developed a recurrence of cutaneous symptoms following ingestion of lemongrass tea. Workers within this industry should be aware of the sensitization potential of these products and the risk of limiting their ability to continue employment.