bluuebunny/crossref_metadata_2025_split huggingface dataset:
Localized linear IgA disease responding to colchicine
Authors: Benbenisty Keith M. , Bowman Paul H. , Davis Loretta S. 
Published: March 2003

A 64‐year‐old white woman presented to our clinic with a 3‐month history of multiple blisters on her right breast which had been unresponsive to acyclovir, amoxicillin/clavulanate and fluconazole. She denied taking any antibiotics prior to the eruption. Physical examination revealed grouped vesicles on an erythematous base and shallow ulcerations in an annular pattern localized to the right breast, without areolar involvement (Fig. 1). There were no oral or mucosal lesions. Past medical history was significant only for a distant history of uterine carcinoma which had been successfully treated with hysterectomy/oophorectomy. No history of liver or autoimmune disease was present. Further examination failed to reveal any history of unusual contact allergens. There was no family history of similar eruptions.Shallow ulcerations and blisters on erythematous bases in an annular patternimagePunch biopsy specimen from lesional skin revealed a subepidermal blister with a dermal infiltrate consisting of numerous neutrophils and scattered eosinophils (Fig. 2). Direct immunofluorescence of perilesional skin demonstrated the presence of a homogeneous linear band of IgA deposits along the dermoepidermal junction and in dermal microvascular basement membranes (Fig. 3). IgG and C3 immunoreactants were not identified.Subepidermal blister with a dermal infiltrate consisting of numerous neutrophils and scattered eosinophils (hematoxylin & eosin, × 20)imageLinear deposits of IgA along the dermoepidermal junction and in dermal microvascular basement membranes (direct immunofluorescence of perilesional skin, × 40)imageAfter starting the patient on oral colchicine, 0.6 mg twice daily, no new blisters appeared, and within 1 week the eruption was nearly resolved. The patient tolerated therapy without any side‐effects, and at a follow‐up visit 5 weeks later had only minimal postinflammatory changes on the skin of the right breast. She then discontinued colchicine and remains free of any recurrence 6 months later.
Cigarette smoking associated with premature facial wrinkling: image analysis of facial skin replicas
Authors: Koh Jae Sook , Kang Hoon , Choi Sung Woo , Kim Hyung Ok 
Published: March 2003

AbstractBackground Despite the obvious relation between smoking and facial wrinkling, grossly undetectable wrinkling and the consequences of smoking on the face have been poorly studied.Objective To assess the risk factor of cigarette smoking on the development of premature facial wrinkling.Methods One hundred and twenty‐three nonsmokers, 160 current smokers, and 67 past smokers, aged 20–69 years, were studied. Cigarette smoking status, weight changes, average sun exposure time (recreational and occupational) in 1 month, and past medical and facial cosmetic surgery were quantified by self‐questionnaire. Computerized image analysis of silicone skin replicas was used in addition to clinical visual measurement, and a severity score based on predetermined criteria was assigned to each patient.Results Current smokers have a higher degree of facial wrinkling than nonsmokers and past smokers. Past smokers who smoked heavily at a younger age show less facial wrinkling than current smokers. In the analysis, which was adjusted for age group, the relative risk of moderate to severe wrinkling for current smokers compared with nonsmokers was 2.72 (confidence interval, CI: 1.32–3.21, P < 0.05). In current smokers, the relative risks associated with more than 19 pack‐years and 11–19 pack‐years of smoking compared with nonsmokers were 2.93 (CI: 1.14–4.1, P < 0.05) and 1.75 (CI: 1.54–3.67, P < 0.05), respectively. On image analysis of facial skin replicas, the mean values of Ra (arithmetic average roughness), Rz (average roughness), and Rt (distance between the highest and lowest values) of current smokers were higher than those of nonsmokers and past smokers in all age groups. This indicates a strong correlation between cigarette smoking and skin wrinkling. In addition, microscopic superficial wrinkling (Ra and Rt) was noted in current smokers in the younger age group (20–39 years).Conclusions This study suggests that attention should be paid to smoking‐associated facial wrinkling (not evident from a visual assessment) in young people and added to the list of disorders seemingly caused by smoking.
Mycetoma in Yemen: clinicoepidemiologic and histopathologic study
Authors: Khatri Mishri Lal , Al‐Halali Hussein Mohammed , Fouad Khalid Mohammed , Saif Sultan Ahmed , Vyas Mehesh Chandra R. 
Published: March 2003

AbstractBackground Mycetoma is widespread in Yemen, but has not been fully documented.Methods A prospective study of 70 patients (53 male, 17 female; from different regions of Yemen) was performed. The clinical profile of the cases was recorded in a special protocol. The diagnosis was based on clinical features, examination of grains, roentgenographic studies, and histopathology (44 cases).Results Fifty cases were diagnosed as eumycetoma and 20 as actinomycetoma. The identification of the causative species was performed in 44 cases by histopathologic studies. Among the cases of eumycetoma, Madurella mycetomatis was recognized in 27 patients, Leptosphaeria senegalensis in two, and pale‐grain fungi in two. Among the cases of actinomycetoma, Streptomyces somaliensis was seen in eight patients, Streptomyces madurae in one, and Nocardia species in four. The treatment of eumycetoma patients with ketoconazole and excision in selected cases controlled the disease activity in the majority. Most of the cases of actinomycetoma were better controlled with drug therapy alone, with a combination of penicillin and cotrimoxazole, or cotrimoxazole alone.Conclusions Mycetoma is widespread in Yemen, with a higher incidence of eumycetoma and a maximum number of cases from the Hudaida region. A multicenter study is needed to evaluate the exact extent of disease.
Sunburn, sunscreens, and phenotypes: some risk factors for cutaneous melanoma in southern Brazil
Authors: Bakos Lucio , Wagner Mario , Bakos Renato M. , Leite Cristina S. M. , Sperhacke Cristina L. , Dzekaniak Karina S. , Gleisner Ana L. M. 
Published: March 2003

AbstractBackground The risk factors for cutaneous malignant melanoma have been studied in populations from numerous countries around the world. There are no published studies on the risk factors for this malignancy in Brazil, the largest country in South America.Methods A case–control study of all melanoma patients attending a university hospital in Porto Alegre, Brazil, was conducted over a 3‐year period from 1995 to 1998. Phototype, hair and eye color, solar habits, history of sunburn, use of sunscreens, and the number of nevi were evaluated through a questionnaire and full body skin examination. Bivariate analysis and a logistic regression model were used to evaluate the data.Results One hundred and three malignant melanoma patients and 206 matched controls were enrolled in the study. The female to male ratio was 2 : 1. Light phototypes were more prone to the development of cutaneous melanoma. Although stronger in the bivariate analysis, in the logistic regression model, phototypes I or II and ephelides emerged only as moderate risk factors; light eye color and light hair color were not independently significant, with adjusted odds ratios (OR) close to zero. Commonly acquired nevi (CAN) showed a significant and strong effect in the bivariate analysis only when the “30 or more” category was compared to baseline. In the logistic regression model, the presence of a large number of CAN showed an association with increased levels of risk, although these findings did not reach classical significance. Dysplastic or atypical nevi seemed to contribute more strongly, although still with a moderate excess of relative risk. When the use of sunscreens was compared to no use at all, it appeared to show progressive protection as the solar protection factor (SPF) increased. Only SPF15 or greater (SPF15+) showed strong and significant protection when compared to baseline. Physical measures offered a weaker level of protection. Nevertheless, there was a significant increase in the risk of melanoma for those with a large number of sunburn episodes. It was found that 30 or more alleged episodes of sunburn showed a very strong OR of 11.4 (95% confidence interval, 2.6–50.5), the most significant in the study.Conclusions Phototypes I and II, freckles, a large number of acquired nevi, dysplastic nevi, and inadequate photoprotection appeared as risk factors with moderate strength for cutaneous malignant melanoma in the studied population. The color of the eyes and hair showed a very weak statistical significance as a risk factor. Sunscreens showed progressive significance corresponding to an increase in SPF, the best scores in statistical protection being achieved in users of sunscreens with SPF15 or greater. Frequent sunburn episodes appeared as the most important risk factor associated with malignant melanoma in this sample of the white population in southern Brazil.
Safe control of palmoplantar hyperhidrosis with direct electrical current
Authors: Karakoç Yunus , Aydemir Ertuğrul H. , Kalkan M. Tunaya , Ünal Gaye 
Published: March 2003

AbstractBackground Primary (idiopathic) hyperhidrosis is a benign disease of unknown etiology, leading to the disruption of professional and social life and emotional problems. A variety of treatment methods have been used to control or reduce the profuse sweating. In this study, we report the efficacy of direct current (d.c.) administration in the treatment of idiopathic hyperhidrosis.Methods One hundred and twelve patients with idiopathic hyperhidrosis were enrolled in the study. Initial sweat intensities of the palms were measured by means of the pad glove method. The patients were treated in eight sessions with d.c. administration using a complete regulated d.c. unit based on tap water iontophoresis. The final sweat intensities of responders were determined 20 days after the last treatment. Nonresponders returned earlier than 20 days, with final sweat intensities measured at least 5 days after the last treatment. In 26 responders, plantar hyperhidrosis was also treated. After the first remission period, the second of eight treatments was applied to the palms of 37 responders.Results This therapy controlled palmar hyperhidrosis in 81.2% of cases. The final sweat intensities of the palms of responders were significantly reduced after eight treatments (P < 0.001). The first average remission period was 35 days. Minimal undesirable effects were noted.Conclusions This technique appears to control hyperhidrosis on the palms and soles only if regular treatment is applied. Plantar hyperhidrosis appeared to resolve simultaneously when palmar hyperhidrosis was successfully treated.
Severe human urticaria produced by ant (Odontomachus bauri, Emery 1892) (Hymenoptera: Formicidae) venom
Authors: Rodriguez‐Acosta Alexis , Reyes‐Lugo Matias 
Published: March 2003

AbstractBackground Ant sting reactions are becoming an increasing problem in tropical countries. It is important for physicians to be aware of their possible cutaneous and systemic manifestations.Methods A child with a severe allergic reaction to an ant sting was examined and is discussed. This is the first case described in the literature caused by the ant Odontomachus bauri, and the biology of the ant and the clinical signs in the patient are described.Results A child developed a strong allergic reaction to an ant sting. The case was not associated with a previous ant sting. Treatment with the systemic antihistamine loratadine (Clarityn®) was favorable in this patient.Conclusions In tropical areas, ant stings are usually benign, self‐limited pathologic processes. In some cases, however, severe allergic reactions can develop, including urticaria and anaphylactic shock. Physicians should be aware of the possible complications of ant stings.
Epidemiology of onychomycosis in patients with diabetes mellitus in India
Authors: Dogra Sunil , Kumar Bhushan , Bhansali Anil , Chakrabarty Arunaloke 
Published: March 2003

AbstractBackground The number of individuals diagnosed with diabetes mellitus is increasing worldwide. Although onychomycosis is often observed in diabetics, there have been no large studies of its epidemiology in this patient group in India.Methods We studied the prevalence of onychomycosis in diabetics attending the Diabetes Clinic at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, and compared it with that in a nondiabetic control group. A total of 400 diabetic subjects (237 males, 163 females), aged 48.8 ± 0.5 years (mean ± SD), were evaluated.Results The prevalence of onychomycosis in the diabetic and control groups was 17% and 6.8%, respectively, the difference being statistically significant (P < 0.001). The presence of onychomycosis was found to correlate significantly with increasing age (P < 0.01) and male gender (P < 0.05) in both diabetic and control groups. From diabetics, yeasts were the most common isolate (48.1%), followed by dermatophytes and nondermatophyte molds in 37% and 14.8%, respectively. In the control group, the distribution of yeasts, dermatophytes, and nondermatophyte molds was 25%, 62.5%, and 12.5%, respectively. After controlling for age and sex, a stepwise logistic regression demonstrated that significant predictors for onychomycosis included the duration of diabetes (P < 0.01), absent or feeble peripheral pulses (P < 0.15), peripheral neuropathy (P < 0.05), and retinopathy (P < 0.001).Conclusions Diabetics were found to be 2.5 times more likely to have onychomycosis than the controls. Predisposing factors included increasing age, male gender, duration of diabetes, impaired peripheral circulation, peripheral neuropathy and retinopathy.
Cryptococcal infection in sarcoidosis
Authors: Mehrany Khosrow , Kist Joseph M. , Gibson Lawrence E. 
Published: March 2003

A 48‐year‐old man with a history of sarcoidosis was transferred to the Mayo Clinic for evaluation and management of progressive neurologic decline. Two years before admission, he was admitted to a local hospital with mental status changes accompanied by ataxia and severe headache. A diagnosis of pulmonary and central nervous system sarcoidosis was made based on computed tomography of the head, lumbar puncture, and chest radiography. A mediastinoscopy with lymph node biopsy exhibited noncaseating granulomas and negative stains for microorganisms. Prednisone therapy was initiated at 80 mg/day. Clinical improvement was apparent for 13 months during steroid therapy until the slow taper reached a dosage of 20 mg/day. At that time, the patient was readmitted to the local hospital with severe confusion and skin lesions. When intravenous methylprednisolone therapy for presumed central nervous system sarcoidosis did not improve the patient's mental status, he was transferred to the Mayo Clinic.Physical examination of the thighs revealed large, well‐marginated, indurated, irregularly bordered, violaceous plaques and rare, umbilicated, satellite papules with central hemorrhagic crusts (Fig. 1A). Superficially ulcerated plaques with a similar appearance to the thigh lesions were coalescing around the lower legs (Fig. 1B). A skin biopsy specimen of the thigh demonstrated abundant numbers of encapsulated organisms and minimal inflammatory response (Fig. 2). Skin, blood, and cerebrospinal fluid cultures confirmed the presence of Cryptococcus neoformans. Amphotericin and flucytosine combination therapy was initiated, and steroid dosages were gradually tapered. A test for human immunodeficiency virus was negative. The patient was dismissed from hospital after a complicated 2‐month course resulting in improved mental status but progression of the lower extremity ulcerations as a result of polymicrobial infection.(A) Violaceous plaque with satellite papules on thigh. (B) Ulcerating plaques coalescing around legimage(A) Sparse inflammatory infiltrate and abundant encapsulated organisms (hematoxylin and eosin; × 20). (B) Cryptococcal organisms (Gomori's methenamine silver; × 40)image
Evidence supporting zinc as an important antioxidant for skin
Authors: Rostan Elizabeth F. , DeBuys Holly V. , Madey Doren L. , Pinnell Sheldon R. 
Published: March 2003

AbstractAntioxidants play a critical role in keeping skin healthy. The antioxidant benefits of vitamin C and E are well known, but the importance of the trace mineral, zinc, has been overlooked. This article reviews the evidence supporting zinc's antioxidant role in protecting against free radical‐induced oxidative damage. Zinc protects against UV radiation, enhances wound healing, contributes to immune and neuropsychiatric functions, and decreases the relative risk of cancer and cardiovascular disease. All body tissues contain zinc; in skin, it is five to six times more concentrated in the epidermis than the dermis. Zinc is required for the normal growth, development and function of mammals. It is an essential element of more than 200 metalloenzymes, including the antioxidant enzyme, superoxide dismutase, and affects their conformity, stability, and activity. Zinc also is important for the proper functioning of the immune system, and for glandular, reproductive and cell health. Abundant evidence demonstrates the antioxidant role of zinc. Topical zinc, in the form of divalent zinc ions, has been reported to provide antioxidant photoprotection for skin. Two antioxidant mechanisms have been proposed for zinc: zinc ions may replace redox active molecules, such as iron and copper, at critical sites in cell membranes and proteins; alternatively, zinc ions may induce the synthesis of metallothionein, sulfhydryl‐rich proteins that protect against free radicals. No matter how they work, topical zinc ions may provide an important and helpful antioxidant defense for skin.
Multiple nonmelanoma skin cancer in an exposed Australian population
Authors: Raasch Beverly A. , Buettner Petra G. 
Published: March 2003

AbstractBackground Patients with nonmelanoma skin cancer (NMSC) frequently develop multiple skin cancers. The study presents incidence rates and rates of excision of NMSC for a population living in a high‐risk environment for skin cancer.Methods Between 1997 and 1999 a prospective population‐based study collected information on all histologically confirmed NMSCs in Townsville, Australia.Results Of the 6708 patients recorded with NMSC, 38.5% had multiple lesions. Yearly age‐standardized incidence rates (per 100,000 inhabitants) of basal cell carcinoma (BCC) were 1444.8 for men, 942.7 for women, and of squamous cell carcinoma (SCC) were 805.0 for men, and 423.6 for women. Compared to incidence rates, age‐standardized rates of lesions of BCC were 2.1 times higher in men, 1.6 times higher in women, and of SCC were 1.8 times higher in men and 1.4 times higher in women.Conclusions The occurrence of multiple NMSCs compromises results of short‐term studies on incidence. Further discussions on the most appropriate strategies to describe the real burden of NMSC are warranted.
Leprosy in type I reaction and diabetes mellitus in a patient with HIV infection
Authors: Belliappa Alamengada D. , Bhat Ramesh M. , Martis Jacintha 
Published: March 2003

A 24‐year‐old man was referred to our department with history of a pale red raised lesion over the right side of the face with impaired sensation of 3 months’ duration. He also had generalized weakness and increased thirst for the past 1 month. He had been treated with multidrug therapy for leprosy for 3 months and oral prednisolone for 1 month by his general practitioner. He also presented with a history of multiple sexual exposures with commercial sex workers and an ulcer over the penis 2 years ago, which healed spontaneously.
Frequent use of tobacco and alcohol in Chinese psoriasis patients
Authors: Zhang Xuejun , Wang Hongyan , Te‐shao Hsu , Yang Sen , Wang Fuxi 
Published: March 2003

AbstractBackground This study aimed to explore smoking and drinking as risk factors in psoriasis.Methods Data collected from 789 psoriasis patients and 789 healthy controls were analyzed to determine whether there was an association between smoking/drinking and psoriasis.Results The proportion of male psoriasis patients using tobacco and alcohol was much higher than that of the control group (P < 10−6), whereas no statistical differences were found between female smokers and the control group. In general, heavy smokers were more likely to have severe psoriasis.Conclusion Tobacco use in patients is correlated with psoriasis.
Value of histopathology in vitiligo
Authors: F. Montes Leopold , Abulafia Jorge , Wilborn Walter H. , Hyde Barbara M. , Montes Carolina M. 
Published: March 2003

AbstractBackground Histopathologic studies of vitiligo have been rather limited in number, thus the microscopic features of this common disorder are not very well known.Subjects and Methods Skin specimens from 20 human vitiligo patients and skin specimens from five equine vitiligo patients were studied by light and transmission electron microscopy.Results and Discussion Absence of melanocytes, increased number of Langerhans’ cells, epidermal vacuolization, thickening of the basement membrane, T‐cell inflammatory infiltrate, and neural alterations were noted in the vitiligo lesions. These results may explain the development of depigmentation, but do not yet fully explain why and how this occurs.
Comparative evaluation of different hair removal lasers in skin types IV, V, and VI
Authors: Galadari Ibrahim 
Published: March 2003

AbstractBackground Lasers permit treatment of unwanted excess hair with less discomfort than other methods of epilation. Many lasers with different parameters are now available from which the dermatologist can choose. Improved clinical results are made possible by the high specificity and selectivity of the laser systems to pigmented hair because of the use of an appropriate wavelength with the proper pulse and duration.Objectives We aimed to compare the results of treatment of skin types IV, V, and VI using three different laser systems.Methods One hundred female patients were compared using different laser systems: 35 patients underwent epilation using a Nd‐Yag laser, 33 patients using an Alexandrite laser, and 32 patients using a Diode laser.Results Follow up 12 months after the multiple treatments (three to six sessions) showed an insignificant difference between these three groups (35–40%).Conclusion Our findings indicate that all three laser systems tested can be used for dark skin; however, one should select a system that minimizes side‐effects, primarily hypo‐ and hyper‐pigmentation, especially when used for skin types IV, V, and VI.
Natural and sexual selection on a plumage signal of status and on morphology in house sparrows, Passer domesticus
Authors: Pape Møller Anders 
Published: March 2003

AbstractTemporal patterns of natural and sexual selection on male badge size and body traits were studied in a population of house sparrows, Passer domesticus. Badge size was a heritable trait as revealed by a significant father‐son regression. Survival during autumn dispersal and winter was not related to badge size or body traits in yearling male house sparrows. Badges that signal dominance status were affected positively by directional selection for mating. Adult male house sparrows suffered an opposing selection pressure on badge size during autumn.Contrary to males, female house sparrows did not experience significant directional or stabilizing selection on any body trait. Directional sexual selection on male badge size due to female choice moves male sparrows away from their survival optimum. Opposing directional natural selection on badge size due to autumn mortality caused by predation maintains a stable badge size.