bluuebunny/crossref_metadata_2025_split huggingface dataset:
Appropriateness of orthodontic referrals: self‐perceived and normative treatment needs of patients referred for orthodontic consultation
Authors: Chew Ming Tak , Aw Andrew Kian‐Li 
Published: March 2003

Abstract  – Objectives: The aims of this prospective study were to evaluate the self‐perceived and normative orthodontic treatment needs of children referred for orthodontic consultation and to determine the proportion of children who were inappropriately referred.Methods: The sample consisted of 257 children with a mean age of 12.0 years (SD = 2.4). An orthodontist assessed the children's normative treatment need using the dental health component (DHC) of the index of orthodontic treatment need (IOTN), and for patients in the mixed dentition the need for interceptive treatment was assessed. Questionnaires were answered by both the child and the parent to assess satisfaction with dental appearance and desire for treatment.Results: The distribution of the IOTN grades showed that 73% of the children had definite need while 27% had borderline/no need for orthodontic treatment. Twenty‐six per cent of children and 17% of parents did not express orthodontic concern, even though more than half of these children were in definite need of treatment as assessed by IOTN. The children's orthodontic concern was significantly related to the DHC scores. Out of the 103 children who were in the mixed dentition, only about 16% required interceptive treatment.Conclusions: The results indicated that a significant number of children were inappropriately referred for orthodontic treatment. Referring dentists need to assess the normative treatment needs of the children as well as the children's and parents' commitment and desire for orthodontic treatment before deciding on the need for referral.
Risk factors for oral soft tissue lesions in an adult Spanish population
Authors: García‐Pola Vallejo M. J. , Martínez Díaz‐Canel A. I. , García Martín J. M. , González García M. 
Published: March 2003

Abstract –Objectives: The aims of this study were (i) to determine the prevalence of oral lesions in adults over 30 years old in the city of Oviedo (Spain), and (ii) to analyze the relationship between the prevalence of oral lesions, toxic habits (tobacco and alcohol) and denture wearers in these patients.Methods: A representative sample of the adult population in Oviedo (Spain) was obtained through randomized sampling (n = 753); a total of 308 (41%) subjects were finally included in the study. The observed oral pathology was classified according to the WHO criteria and earlier epidemiological studies.Results: A little over half of all patients (51.1%) had oral lesions. The most frequent lesions were frictional lesion (7.5%), traumatic ulcer (7.1%), denture stomatitis and pseudomembranous candidosis (6.5%), followed by melanin pigmentation (5.8%) and denture‐induced hyperplasia (5.2%), plicated tongue (3.9%), lichen planus and hemangioma (3.2%), angular cheilitis and cheek biting (2.9%), fibrous hyperplasia and coated tongue (2.6%), recurrent aphthae (1.9%) and oral leukoplakia (1.6%). In relation to leukoplakia, the odds ratio (OR) of heavy drinkers was 15.98 and the OR of heavy smokers was 12.37. The OR of heavy smokers or heavy drinkers diagnosed of frictional lesion was four times greater than that of nonsmokers or nondrinkers. The OR of heavy smokers with melanic pigmentations was 4.08. The OR of complete denture wearers with candidosis was 11.38. The OR of partial removable denture wearers with hemangioma was 5.01.Conclusions: This study shows the relation of heavy tobacco and heavy alcohol to traumatic keratosis and leukoplakia, and of complete dentures to pseudomembranous candidosis, fibrous hyperplasia and stomatitis. Programs designed to eradicate toxic factors (alcohol and tobacco) should, therefore, be implemented with adequate maintenance of dentures.
Oro‐facial pain in the community: prevalence and associated impact
Authors: Macfarlane Tatiana V. , Blinkhorn Anthony S. , Davies Robin M. , Kincey John , Worthington Helen V. 
Published: March 2003

Abstract Study objective: To determine the prevalence of oro‐facial pain (OFP) in the population and within‐population subgroups and to describe the associated disability. Design: Cross‐sectional population study. Setting: General medical practice in South East Cheshire, United Kingdom. Participants: A random sample of 4000 adults aged 18–65 years of whom 2504 responded (adjusted participation rate 74%). Main results: The overall prevalence of OFP was 26% (95% Confidence Interval (CI) 24%, 28%). The prevalence of symptoms was higher in women (30%) than in men (21%) and in both sexes the highest (30%) prevalence was found in the 18–25 year age group and the lowest (22%) in the 56–65 age group. Of all the participants, 12% had pain in or around the eyes, 10% reported pain in and around the temples, 6% pain in front of the ears and 6% pain in the jaw joints. Only 46% of the participants with OFP had sought professional advice from a dentist or general medical practitioner and 17% had to take time off work or were unable to carry out normal activities because of pain. Conclusions: OFP is a common symptom experienced by a quarter of the adult population, of whom only 46% seek treatment. The prevalence is higher in women and younger age groups.
A fatal case of pancreatic panniculitis presenting in a young patient with systemic lupus
Authors: Cutlan Robert T. , Wesche William A. , Jenkins Jesse J. , Chesney Thomas M. 
Published: March 2003

Background: Subcutaneous fat necrosis associated with pancreatic disease is a rare event. The clinical cutaneous findings are non‐specific erythematous nodules with central softening located predominantly on the lower extremities. The histopathologic features of these lesions are very characteristic and diagnostic.Methods: We present an unusual case of pancreatic panniculitis associated with lupus pancreatitis in a 21‐year‐old African American female. The patient presented with lower extremity skin nodules, arthralgia, and serositis prior to the diagnosis of systemic lupus and pancreatitis. The skin lesions progressed despite normalization of serum pancreatic enzymes. Following femoral vein catheterization for renal dialysis, she developed a large indurated area over the left lower quadrant, flank, groin, and upper thigh measuring 25 cm. She was treated with repeated debridement, tissue grafts, and hyperbaric oxygen because of a clinical suspicion of necrotizing fasciitis.Results: Examination of skin biopsies and debrided tissue revealed the pathognomonic features of pancreatic panniculitis without any evidence of necrotizing fasciitis. Organisms were not detected by tissue examination or microbiologic cultures.Conclusions: This case illustrates the potential role of vascular trauma in the pathogenesis of pancreatic panniculitis.
Palisaded angioleiomyoma
Authors: Baugh William , Quigley Michael M. , Barrett Terry L. 
Published: March 2003

Background: We report a case of a palisaded angioleiomyoma, a histopathologic variant of angioleiomyoma with prominent Verocay body formation.Results: A healthy 31‐year‐old male requested removal of a subcutaneous nodule on the back of his head. The striking Verocay‐like body formation of this tumor led to an initial frozen section diagnosis of neurilemoma. On hematoxylin and eosin staining, areas consistent with an angioleiomyoma were found as well. Immunohistochemistry gave positive reactions for actin and desmin, but was negative for S‐100.Conclusions: To our knowledge this morphologic pattern in an angioleiomyoma has not been previously described. Palisaded angioleiomyoma should be added to the ever‐expanding list of tumors that demonstrate nuclear palisades.
Acute generalized exanthematous pustulosis (AGEP) – A clinical reaction pattern
Authors: Sidoroff Alexis , Halevy Sima , Bavinck Jan Nico Bouwes , Vaillant Loïc , Roujeau Jean‐Claude 
Published: March 2003

Background: A wide range of diseases or reactions can cause pustular eruptions of the skin. In this spectrum there seems to be a subgroup with characteristic clinical features and a typical course which is mostly caused by drugs for which the term acute generalized exanthematous pustulosis (AGEP) has been established.Objective: To describe the clinical features of AGEP.Methods: The authors’ experience from a multinational epidemiological study on severe cutaneous adverse reactions and a comprehensive review of the literature were used to provide an overview of the disease and it’s possible causes. An algorithm for validating cases which was established for this study is also presented.Results: AGEP typically presents with at least dozens of non follicular sterile pustules occurring on a diffuse, edematous erythema predominalty in the folds and/or on the face. Fever and elevated blood neutrophils are common. Histopathology typically shows spongiform subcorneal and/or intraepidermal pustules, a marked edema of the papillary dermis, and eventually vasculitis, eosinophils and/or focal necrosis of keratinocytes. Onset is acute, most often following drug intake, but viral infections can also trigger the disease. Pustules resolve spontaneously in less than 15 days.Conclusion: The diagnosis AGEP should be considered in cases of acute pustular rashes and detection of the causative drug should be strived for. Knowledge of the clinical features and usual course of this disease can often prevent unnecessary therapeutical measures.
Dermal dendritic cells in anogenital warty lesions unresponsive to an immune‐response modifier
Authors: Arrese Jorge E. , Paquet Philippe , Claessens Nadine , Piérard‐Franchimont Claudine , Piérard Gérald E. 
Published: March 2003

Background: Human papilloma viruses (HPV) are responsible for a variety of proliferative epithelial lesions including anogenital condylomas. These lesions may regress during treatment with an immune‐response modifier such as imiquimod. The release of specific cytokines from the monocyte‐macrophage lineage induces a cascade of events abating the HPV replication.Method: A total of 14 persistent warty anogenital lesions were excised 4 to 7 weeks after completing a 4‐month imiquimod treatment. Another series of 25 untreated condylomas and 8 bowenoid papulosis served as controls. All examined lesions had been excised in otherwise healthy individuals with a normal immune status. Lesions were examined for the presence of Langerhans cells and subpopulations of the monocyte/macrophage/dendrocyte lineage using immunohistochemical detection of L1‐protein, CD68, lysozyme and Factor‐XIIIa. CD45R0‐positive T lymphocytes were also identified. HPV capsid antigens and genotypes were searched for using immunohistochemistry and in situ hybridization, respectively.Results: The persistent although treated anogenital lesions were identified as 10 viral condylomas, 3 bowenoid papulosis and 1 basal cell carcinoma. The inflammatory cell densities and distributions were similar in the untreated and imiquimod‐resistant condylomas with the exception of Factor XIIIa‐positive dendrocytes. These dermal dendritic cells were slim and rare in all imiquimod‐resistant lesions. In contrast, about two‐thirds of the untreated condylomas were enriched in these cells.Conclusion: As dermal dendritic cells play a role in the immune surveillance, their low densities in some lesions might be a key feature responsible for low cytokine local production and failure of imiquimod treatment. The combined apparent lack of Langerhans cell activation might suggest that both intraepidermal and intradermal compartments of antigen‐presenting cells are affected in imiquimod‐resistant lesions.
Expression of Basigin in human fetal, infantile and adult skin and in basal cell carcinoma
Authors: Chen Xiang , Kanekura Takuro , Kanzaki Tamotsu 
Published: March 2003

Background: Basigin is a glycosylated transmembrane protein belonging to the immunoglobulin superfamily and is thought to be associated with cell development and differentiation. We investigated the relation between Basigin expression and epidermal development in this study.Methods: Basigin expression was immunohistochemically investigated during organogenesis of human skin and in human basal cell carcinoma (BCC).Results: Human fetal skin showed negative staining at 10 weeks of gestation. At 20 weeks, the cytoplasm and membranes of adnexal germ and hair follicular cells were strongly positive, while epidermal basal cells showed weakly positive staining. After birth, basal cells, suprabasal cells, anagen hair follicular cells and eccrine glandular cells showed positive staining. Membranes of basal cells expressed more Basigin compared to other cell components. Basigin was not detectable in granular cells and telogen hair follicular cells. Sixteen of 30 BCCs were entirely negative for Basigin. However, cells at budding areas of tumor masses were positive in 14 of the 30 BCCs.Conclusions: These findings suggest that 1) Basigin is associated with epidermal proliferation and differentiation, 2) most parts of BCCs might be derived from early fetal epidermal basal cells, and 3) that a part, only the budding area of BCCs, has the characteristics of epithelial germ cells.
The clonality of tumor‐infiltrating lymphocytes in African Kaposi’s sarcoma
Authors: Nihal Minakshi , Mikkola Debra , Qian Zheng , Remick Scot C. , Wood Gary S. 
Published: March 2003

Background: African Kaposi’s sarcoma (KS) lesions contain human herpesvirus‐8 (HHV‐8) and Epstein‐Barr virus (EBV), both of which are associated with various types of non‐Hodgkin’s lymphomas and are known to produce several factors suspected of lymphomagenic potential. The aim of this study was to evaluate tumor‐infiltrating lymphocytes for the evidence of clonal expansion in African KS.Methods: We used polymerase chain reaction (PCR)‐based assays to determine the clonality of tumor‐infiltrating lymphocytes in African KS lesions and compared the results to similar studies of patient‐matched uninvolved skin and peripheral blood.Results: T cells were polyclonal in all samples tested. Peripheral blood B cells were also polyclonal; however, a minority of lesional and uninvolved skin samples exhibited evidence of restricted B‐cell clonality. Correlation with immunohistological analysis revealed that this clonal B‐cell restriction was secondary to the sparse nature of lesional B cells rather than their clonal overgrowth.Conclusions: We conclude that, despite the putative lymphomagenic potential of HHV‐8 and EBV and their co‐existence in African KS lesions, tumor‐infiltrating lymphocytes in these cases do not show evidence of clonal expansion that might be an early manifestation of lymphoma. Nevertheless, these studies are a case in point that sparse lymphoid subpopulations in lesional and uninvolved extranodal tissues can give rise to restricted clonal patterns that must be interpreted carefully to avoid the misdiagnosis of occult lymphoma.
S100A6 expression in fibrohistiocytic lesions
Authors: Fullen D. R. , Reed J. A. , Finnerty B. , McNutt N. S. 
Published: March 2003

Background: S100A6, an S100 calcium‐binding protein, has been found in a variety of cutaneous and extracutaneous lesions including: melanocytic nevi, melanoma, some salivary gland and epithelial tumors, and malignant fibrous histiocytoma (MFH). Dermal dendrocytes (DD) in the papillary dermis of skin also express S100A6 protein. We evaluated a variety of cutaneous fibrohistiocytic lesions to determine if the immunophenotype of S100A6 positivity can be expanded to include some or all of these lesions.Methods: Formalin‐fixed, paraffin‐embedded tissues from fibrous papules (FP, 20), dermatofibromas (DF, 20), dermatofibrosarcoma protuberans (DFSP, 5), atypical fibroxanthomas (AFX, 5), oral fibromas (3), digital fibroma (1), and dermatomyofibroma (1) were evaluated with antibodies to S100A6, S100B, factor XIIIa, and MAC387 using a one‐hour capillary action‐based immunohistochemical procedure.Results: DD in 20/20 FP, 19/20 DF, and 4/4 fibromas stained positively with anti‐S100A6 in a pattern similar to anti‐factor XIIIa. No DFSP cases stained with anti‐S100A6. Anti‐S100A6 showed superior staining to anti‐factor XIIIa in 4/5 AFX cases.Conclusions: The immunophenotypes of some fibrohistiocytic lesions can be expanded to include S100A6 protein. With the exception of AFX, the use of anti‐S100A6 does not appear to offer added benefit over anti‐factor XIIIa in the differential diagnosis of fibrohistiocytic lesions.
Cutaneous lymphocyte‐associated antigen (CLA) expression in a lymphoblastoid mantle cell lymphoma presenting with skin lesions. Comparison with other clinicopathologic presentations of mantle cell lymphomaNote
Authors: Martí R. M. , Campo E. , Bosch F. , Palou J. , Estrach T. 
Published: March 2003

Background: Cutaneous lymphocyte‐associated antigen (CLA) is a lymphocyte homing receptor selectively expressed by T cells of the cutaneous immune system and their malignant counterpart, that is to say, cutaneous T‐cell lymphomas. However it is absent in the vast mayority of other T‐cell malignancies and B‐cell lineage lymphomas irrespective on primary tumor site.Methods: Expression of CLA was investigated on six cases of mantle cell lymphoma (MCL) which differed in their histopathological subtype (typical or blastic) and their tendency to infiltrate skin and/or central nervous system (CNS).Results: CLA immunostaining on neoplastic cells was only observed in a 61‐year‐old female suffering from a lymphoblastoid MCL which clinically presented with specific skin lesions and further developped CNS disease. In this patient, coexpression of CLA with MCL markers (CD20 and CD5) was confirmed by conventional immunohistochemistry and double immunofluorescence studies.Conclusions: To our knowledge, CLA immunoreactivity on B‐cell lymphomas has not beeen previously reported. The expression of this skin‐related adhesion molecule on malignant MCL cells could explain the clinical behavior of our case which presented and relapsed with cutaneous lesions. However, CLA seems not to be a MCL marker nor a CNS‐related adhesion molecule. The authors review the clinical and histopathological characteristics of MCL‐specific skin lesions and their diagnostic clues based on cell morphology, immunohistochemistry and molecular investigations.
Immunohistochemical study of inducible nitric oxide synthase in skin cancers
Authors: Kagoura Masayori , Matsui Chihiro , Toyoda Masahiko , Morohashi Masaaki 
Published: March 2003

Background: Nitric oxide (NO) is synthesized from the amino acid L‐arginine by NO synthase (NOS). Experimental evidence suggests that increased express of inducible NOS (iNOS), which is an NOS isoform and calcium independent, is related to various pathological processes, such as inflammation and cancer.Methods: In this study, we used immunohistochemistry to investigate iNOS expression in a series of basal cell carcinomas (BCC), Bowen’s disease, squamous cell carcinomas (SCC), extramammary Paget’s disease (EPD) and metastatic tumors of the skin.Results: Only 1 of 16 BCC cases was positive for iNOS and the intensity of staining was weak. In most of the 10 cases of Bowen’s disease, iNOS was weakly expressed and there was a wide range in the percentage of positive tumor cells. Twelve of the 16 cases of SCC were positive for iNOS and the extent of positivity was greater than in Bowen’s disease. Two of the 7 cases of EPD were positive for iNOS, and 12 of the 15 cases of metastatic cancer were positive. Well‐differentiated adenocarcinomas were diffusely positive, whereas poorly‐differentiated ones showed strong and heterogeneous staining.Conclusions: These results indicated that the expression of iNOS may reflect the proliferation of tumor cells and that a heterogeneous distribution of iNOS may correlate with a wide variety of biological behavior of tumor cells.
Heteroduplex analysis of T‐cell receptor γ gene rearrangement as an adjuvant diagnostic tool in skin biopsies for erythroderma
Authors: Cherny Sarah , Mraz Serena , Su Lyndon , Harvell Jeff , Kohler Sabine 
Published: March 2003

Background: Erythroderma, defined as red skin covering most of the body surface often accompanied or followed by exfoliation, is the clinical manifestation of at least six different underlying etiologies with allergic or irritant contact dermatitis, atopic/asteotic dermatitis, pityriasis rubra pilaris (PRP), psoriasis, and seborrheic dermatitis accounting for the majority of cases. Approximately 10% of cases are due to adverse drug reactions with roughly another 10% due to cutaneous T‐cell lymphoma (CTCL), predominantly mycosis fungoides, or leukemia. It is clear from multiple studies that the clinical diagnosis of the underlying entity is often difficult, as these diseases can present in a very similar fashion. A skin biopsy is usually employed in this setting as a diagnostic tool. However, the histopathologic diagnosis of the underlying cause is complicated by the subtlety of the distinguishing histologic features. In this situation, an ancillary technique demonstrating the presence of a monoclonal T‐cell proliferation could help to rule in or out CTCL in cases that clinically and histopathologically do not allow a definitive diagnosis.Methods: We retrospectively studied 25 biopsies from sixteen patients who presented to the Stanford Dermatology Clinic with erythroderma. We examined the specimens morphologically and analyzed the gamma chain of the T‐cell receptor (TCR‐ γ) by polymerase chain reaction (PCR) followed by heteroduplex analysis for clonality. We then correlated the results of our PCR and heteroduplex analyses with the patients’ clinical outcomes.Results: Four biopsies, from three patients, contained clonal TCR‐γ rearrangements; the four biopsies, all of which were equivocal histologically, correlated to diagnoses of mycosis fungoides (MF) or Sézary syndrome (SS). Twenty‐one biopsies contained polyclonal T‐cell populations. Eighteen of these biopsies represent patients with inflammatory dermatoses. Three of these biopsies, all of which were taken from a single patient, correlate to a diagnosis of MF.Conclusion: TCR‐γ PCR heteroduplex analysis seems to represent an important adjuvant diagnostic tool that, used in conjunction with histopathology and clinical history, could help to clarify the underlying etiology of erythroderma.
Polymerase chain reaction (PCR) for human herpesvirus 8 and heteroduplex PCR for clonality assessment in angiolymphoid hyperplasia with eosinophilia and Kimura’s disease
Authors: Jang Kyoung‐Ae , Ahn Se‐Jin , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung , Shim Yong‐Hee 
Published: March 2003

Background: Recently, human herpesvirus 8 (HHV‐8) has been isolated from almost all cases of Kaposi’s sarcoma. It has not been found in most cutaneous hemangioproliferative disorders other than Kaposi’s sarcoma. Benign vascular lesions including Kimura’s disease were not found to contain the HHV‐8 DNA sequence. However, there has been contradictory data concerning the presence of HHV‐8 in angiolymphoid hyperplasia with eosinophilia (ALHE). Clonality studies in ALHE and Kimura’s disease were rare.Methods: We performed polymerase chain reaction (PCR)‐based analysis to determine whether HHV‐8 is present and heteroduplex analysis of rearranged T‐cell receptor (TCR) gene for clonality assessment in paraffin‐embedded skin biopsy samples of 7 ALHE and 2 Kimura’s disease, taken from immunocompetent patients.Results: HHV‐8 could not be identified in all the cases of ALHE and Kimura’s disease. Although 2 cases (2/7) of ALHE and 2 cases(2/2) of Kimura’s disease showed positive result for PCR analysis of TCR, all the cases were negative for heteroduplex‐PCR.Conclusions: We suggest that HHV‐8 may not involve in a pathogenetic role in ALHE and Kimura’s disease and the failure to demonstrate clonality may be consistent with the reactive nature of these diseases and lack of malignant transformation. In addition, heteroduplex‐PCR can be applied to confirm doubtful cases of lymphoma in that heteroduplex‐PCR is more specific than PCR as seen in our study.