bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double‐labeled immunofluorescence study of cutaneous nerves in psoriasis
Authors: Jiang Wen‐Yue , Raychaudhuri Siba P. , Farber Eugene M. 
Published: March 2003

Abstract Background and objective In recent years, many reports have suggested an active role of neuropeptides in the pathogenesis of psoriasis. Increased numbers of neuropeptide‐containing nerves positive for substance P (SP), vasoactive intestinal polypeptide (VIP), and calcium gene‐related peptide (CGRP) have been reported in psoriatic tissue. As psoriatic epidermis has a larger mass/volume, however, it is expected to have more nerves and a higher number of neuropeptergic fibers. Therefore, instead of demonstrating a larger number of neuropeptergic fibers, a more significant study is to investigate whether the neuropeptergic fibers are denser in psoriatic tissue. In this study, we applied a double labeled immunofluorescence technique. This method allows the identification of the total number of nerve fibers and the number of nerves positive for specific neuropeptides. Materials and methods We obtained biopsies from nine lesional and seven non‐lesional psoriatic skins and six normal controls. Biopsies were snap frozen and then cut into 14 μm cryosections. The tissues were first treated with anti‐microtubule associated protein (MAP)2 antibody to stain the nerves. This was followed by a second set of stainings for SP, VIP, and CGRP. Primary antibodies were used in dilutions of 1 : 200 for anti‐MAP2, 1 : 200 for anti‐SP, 1 : 800 for anti‐VIP, and 1 : 400 for anti‐CGRP. Results We found that the percentage of SP‐positive fibers was twofold greater and the percentage of CGRP‐positive fibers was 2.5 times greater in the psoriatic epidermis than in the epidermis of normal skin. Psoriatic epidermis had 30.1 ± 3.9% SP‐positive nerve fibers compared with 15.7 ± 3.7% in the normal control. The corresponding values for CGRP‐positive nerve fibers were 30.1 ± 3.9% and 12.0 ± 4.2%. Conclusions The results of our study suggest that SP‐ and CGRP‐containing neuropeptide nerve fibers are more dense in the psoriatic epidermis. Both SP and CGRP are chemotactic to neutrophils and mitogenic to keratinocytes and endothelial cells. In addition, SP activates T lymphocytes and induces adhesion molecules on the endothelial cells. Our observations suggest that neuropeptides may play a significant role in the inflammatory and proliferative process of psoriasis.
The efficacy of low‐dose oral corticosteroids in the treatment of vitiligo patients
Authors: Kim Soo Min , Lee Han‐Seung , Hann Seung‐Kyung 
Published: March 2003

Abstract Background One of the most probable pathogeneses of vitiligo is autoimmunity. Systemic corticosteroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. The clinical efficacy of low‐dose oral corticosteroids was assessed to minimize the side‐effects in actively spreading vitiligo patients. Methods Eighty‐one patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3 mg/kg body weight) initially for 2 months; the dosage was then reduced to half of the initial dose for the third month and was halved again for the fourth and final month. The effects of treatment were evaluated using photographs of before and after the study. Side‐effects were assessed at the first, second, third and fourth month of treatment. Results Arrested progression of vitiligo and repigmentation were noted in 87.7% and 70.4% of patients respectively. Male sex, a patient age of 15 years or under, and a duration of disease of 2 years or less showed increased repigmentation with statistical significance. The side‐effects of treatment were minimal and did not affect the course of treatment. Conclusions Low‐dose oral corticosteroids are effective without serious side‐effects in preventing the progression and inducing repigmentation of actively spreading vitiligo, which is difficult to treat with topical corticosteroids or photochemotherapy.
Allergic contact dermatitis in the United Arab Emirates
Authors: Lestringant Gilles G. , Bener Abdulbari , Sawaya Maha , Galadari Ibrahim H. , Frossard Philippe M. 
Published: March 2003

Abstract Background No data exist on allergic contact dermatitis (ACD) in the United Arab Emirates (UAE). Aim Our aim was threefold: (i) to determine the incidence of ACD; (ii) to identify responsible allergens using the European Standard Series, TRUE TEST, and other substances; (iii) to tentatively explore population‐specific reactions in Al Ain, UAE. Design This is a prospective, descriptive, hospital‐based, study. Setting Tawam Hospital, Al Ain Medical District, UAE. Patients During the years 1989–1996, 373 patients (male : female = 2 : 3), presenting with cutaneous manifestations possibly related to contact allergy, were patch tested. Results 93.8% of patients presented with dermatitis affecting mostly the hands (45.1%), feet (21.4%), face (12.6%), and legs (4.6%). Two hundred and twenty‐four patients (60%) (male : female = 1 : 2) tested positive for at least one substance. Nickel was the commonest sensitizer (15%) in both genders. “Fragrance mix” (8%), p‐tertiary butylphenolformaldehyde (p‐TBPF) resin (7.5%), thiomersal (7.5%), chromium (7.2%), cobalt (6.4%), ethylenediamine (6.4%), neomycin (5.1%), and parabens (5.1%) were prominent allergens. Glutardialdehyde, an additional substance tested together with the European Standard Series, scored significantly (4.8%). Variations from the results reported from other countries may be explained by the specific lifestyles and customs of the UAE population. Conclusions Substances contained in the TRUE TEST, plus glutardialdehyde, may be considered as the standard series for patch testing in the UAE population.
Elephantiasis nostras verrucosa
Authors: Vaccaro Mario , Borgia Francesco , Guarneri Fabrizio , Cannavò Serafinella P. 
Published: March 2003

A 62‐year‐old white man was referred to our department in May 1998 because of the progressive development of chronic lymphedema on the lower extremities; since the age of 58 years, he had noted recurrent swelling with bilateral edema involving, at first, the dorsum of the feet and, later, both the front and the back of the legs, leading to the advancing deformation of the entire extremities.His medical history was significant for congestive heart failure and severe obesity; anamnestic investigation was negative for filariasis and familial Milroy's disease.Physical examination revealed a man in poor health with diffuse thickening of both feet and legs, accompanied by profound, nonpitting edema, generalized lichenification, and cobblestone‐like skin surface. Severely malodorous verrucous plaques were present on the calves; ulcerative lesions were also noted on the medial malleolus of the left extremity( Fig. 1). The toes of both feet showed marked pachyonychia and signs of onycogryphosis.Physical examination shows nonpitting edema, generalized lichenification, and cobblestone‐like skin surface with ulcerative lesionsimagePosterior tibial and dorsal pedis pulses were not palpable bilaterally. Laboratory tests revealed slightly elevated serum levels of sugar, triglycerides, and cholesterol. Repeated cultures from lesional areas showed Trichophyton rubrum, Candida albicans, and β‐hemolytic Streptococcus group A.A surgical biopsy specimen obtained from the edge of the ulcer showed hyperkeratosis with parakeratosis and acanthosis of the epidermis; diffuse edema and multiple dilated lymphatic spaces throughout the papillary and reticular dermis were observed. There was no sign of neoplastic change ( Fig. 2).Histology shows hyperkeratosis with parakeratosis and acanthosis, and diffuse dermal edema with multiple dilated lymphatic spaces (hematoxylin and eosin stain; original magnification, × 40)imageThe patient was given oral itraconazole 200 mg/day and amoxicillin plus clavunalate 1 g twice daily, but treatment was stopped because of the increased cardiac decompensation and subsequent death.
Pattern of skin diseases at the University Teaching Hospital, Addis Ababa, Ethiopia
Authors: Shibeshi Dagnatchew 
Published: March 2003

AbstractBackground and objective  Skin diseases are among the leading causes of hospital visits in Ethiopia. An analysis was performed to describe the pattern of skin diseases at a teaching hospital in Addis Ababa, Ethiopia.Patients and methods  All consecutive new patients seen at the dermatologic referral clinic of Black Lion Teaching Hospital (BLH) from June 1995 to July 1997 were included in this prospective analysis. The clinical examinations were performed by the author, so that uniformity of diagnosis and classification is assured.Results  A total of 1505 patients were assessed; 1093 (72.6%) were in the age group 21–40 years, and the female to male ratio was 1.2 to 1. The most common skin diseases were allergic skin diseases (25.5%), infections (25.4%), the photodermatoses (22.9%), followed by papulosquamous diseases (11.4%) and pruritis of unknown origin (3.3%). Skin manifestations of collagen diseases were less common findings (0.7%).Conclusions  The pattern of skin diseases observed in this analysis shows that allergic and infectious causes account for three‐quarters of skin problems. Emphasis should be given to this group of common skin diseases at all levels of health care so that proper diagnosis, treatment, and referral can be practiced.
Eccrine poroma of the heel
Authors: Lemont Harvey ,   DPM, Snyder Heather ,   DPM
Published: March 2003

A 67‐year‐old African–American woman had a tender red nodule on the posterior aspect of her left heel of 20 years' duration. The lesion had initially grown quickly to its present size, but subsequently remained unchanged through the years. No previous history of trauma to the area could be elicited. The lesion was not tender or painful, although the patient related some recent discomfort when wearing shoes with high heel counters. Examination revealed a soft, multilobulated, skin‐colored nodule, measuring approximately 1.1 cm at its greatest diameter ( Fig. 1), with a rim space or moat (
Fig. 2) surrounding the lesion. Biopsy of the lesion demonstrated a uniform proliferation of basaloid cells exhibiting a sharp demarcation between the adjacent normal epidermis (
Fig. 3). No horn cysts were present. The papillary dermis demonstrated multiple ectatic blood vessels (
Fig. 4) which may be responsible for its reddish appearance.red, granulating lesion on the posterior heelimagethe characteristic ‘‘moat’' surrounding the lesionimagereveals a proliferation of uniformly small cuboidal cells sharply demarcated from the adjacent normal epidermal cellsimagevessel dilatation most likely responsible for the reddish color of the lesionimage
Suction blister grafting for stable vitiligo using pulsed erbium:YAG laser ablation for recipient site
Authors: Sachdev Mukta , Krupashankar Devasthanam Sundara Rao ,   DVD
Published: March 2003

Abstract Background Suction blister grafting was performed via a modified simple technique using a 20‐mL syringe to create the donor graft and pulsed erbium:YAG laser ablation of the recipient site. Methods Two patients with stable vitiligo and one with postinflammatory depigmentation were studied. Results The grafts took well in all three patients and pigmentation was retained at 20 weeks. No complications occurred. Conclusions The erbium:YAG laser is an ideal tool for creating graft recipient sites, given its precision in terms of width and depth of ablation. A 20‐mL syringe can be used to create a blister of adequate size.
Prurigo in a patient with intestinal strongyloidiasis
Authors: Albanese Giancarlo , Venturi Caterina , Galbiati Giuseppe 
Published: March 2003

A 22‐year‐old Senegalese man, who had been in Italy for 2 years, in a good general state of health and with an unremarkable medical history, had been suffering for an unspecified length of time from widespread itching, along with the gradual appearance of numerous keratotic nodular lesions, sometimes interspersed with areas of lichenification in a picture of progressive xerosis ( Fig. 1). During a previous stay in our hospital department, he had suffered a serious attack of asthma, with hypereosinophilia (19%) and an increase in serologic immunoglobulin E (IgE) (2000 IU/mL).Clinical view of the lesions on the left legimageA histologic examination of a lesion removed from the patient's back revealed the presence of slight acanthosis and an inflammatory infiltrate in the surface and middle dermis, mainly consisting of lymphocytes and a few eosinophils ( Fig. 2).Histologic view of a lesion (hematoxylin and eosin, × 250)imageA parasitologic examination of the feces revealed the cause of the clinical picture, and led to the identification of Strongyloides stercoralis (
Fig. 3). The patient was subjected to a short cycle of treatment with albendazole, 400 mg/day for three consecutive days.Parasite isolated from the feces (direct examination, × 100)imageThe patient was kept under observation for the next 6 months, and his clinical picture and symptomatology slowly but gradually improved. Examination of the feces gave a negative result.
Poroid hidradenoma
Authors: Cho Soyun , Kim Ji‐Sook , Shin Joung‐Hyun , Kim Jin‐Hyoung , Kim Hyun‐Joo , Whang Kyu‐Kwang , Hahm Jeong‐Hee 
Published: March 2003

A 36‐year‐old Korean man presented with a nodular lesion on the buttock. It was a walnut‐sized, tender, soft, and movable nodule covered by normal skin which had been enlarging steadily over a period of one year ( Fig. 1). Surgical exploration revealed the tumor to be a cyst containing serous, brownish fluid. It was totally excised. Histological examination showed a well‐demarcated, 1.3 × 0.9 cm tumor with cyst formation in the center and surrounded by a zone of connective tissue in the middle and lower dermis, without any connection to the overlying epidermis (
Fig. 2a). The cystic wall was composed of tumor cells. Variably sized tumor lobules protruded into the cystic space. The tumor nests consisted of two cell types: smaller, darker poroid cells and larger, paler cuticular cells. Mitotic figures were not present. Vacuolar spaces were seen within the cytoplasm of some cuticular cells, which were thought to represent early stages of ductal differentiation. Ductal structures lined by eosinophilic cuticle were present in some tumor lobules (
Fig. 2b). Peripheral pallisading was occasionally observed, but it was not a prominent feature] the cells at the edges of the lobules tended to be rather flattened. Periodic acid‐Schiff stain with diastase demonstrated variable amounts of glycogen within the cytoplasm of some tumor cells. Carcinoembryonic antigen (CEA) immunostaining was positive in the luminal border of the cystic space, which appeared as a sensitive marker of ductal differentiation. Epithelial membrane antigen also showed a positive reaction in luminal borders of the cystic space. Tumor cells were positive for vimentin, but negative for S‐100 protein] however, many dendritic cells scattered throughout the neoplasm were positive for S‐100 protein.A  walnut‐sized, tender, soft, movable nodule covered by normal skin is seen on the buttock.image(a)  A well‐demarcated tumor with cyst formation in the center is surrounded by a zone of connective tissue in the middle and lower dermis, without any connection to the overlying epidermis. Solid parts protrude into the cystic space (hematoxylin and eosin; original magnification × 40). (b)  Ductal structure lined by eosinophilic cuticle is surrounded by cuticular tumor cells (hematoxylin and eosin; original magnification × 200).image
Human cowpox infection in Sharkia Governorate, Egypt
Authors: Amer Mohamed , El‐Gharib I. , Rashed A. , Farag F. , Emara M. 
Published: March 2003

Abstract Background and objective  In the last few years, outbreaks of an apparently specific dermatosis occurred during the months of late summer and early autumn in our locality. Our aim in this study was to reveal the underlying etiology of this dermatosis.Subjects and methods  Sixty patients with the disease were studied clinically, epidemiologically, histopathologically, and ultrastructurally.Results  The results of all methods suggest that the dermatosis is most probably a human cowpox infection. Electron microscopy showed unenveloped cowpox virons.Conclusions  This apparently specific dermatosis is due to human cowpox infection. Future investigations will be needed to better define this important zoonosis frequently passed by cats to humans and carried by rodents.
Familial koilonychia
Authors: Gao Xing‐Hua , Li Xiaodong , Zhao Yuming , Wang Yakun , Chen Hong‐Duo 
Published: March 2003

A 2‐year‐old boy with flat and spoon‐shaped nail plates was referred to us. His mother had noticed that his fingernails were quite soft when he was born. After 2 months, the nails became flat or spoon‐shaped; the toenail plates also became rough and flat. Systemic examination revealed nothing unusual. All his fingernail plates were quite thin, and had concave surfaces; the distal edges of some nail plates were rough and darkened (Fig. 1). His great, second and middle toenails on both sides showed the same abnormalities as the fingernails. Routine laboratory tests were normal; serum levels of iron, zinc, calcium, and magnesium were within normal limits. Repeated microscopic examination and culture of fungi from both fingernails and toenails were negative. Histologic examination of the distal edges of some of his fingernail plates was basically normal.The proband has concave fingernail plates with rough and light brown distal edgesimageWhen checking members of the family, we noticed that the boy's mother and maternal grandmother had similar nail problems (out of 14 members of three generations), although no systemic or other skin disorders were noticed. All the fingernails of the boy's mother were lusterless and concave with darkening of the distal edges (Fig. 2). All her toenails were rough, lusterless, and brown; some of them had longitudinal ridges. His maternal grandmother had light brown colored fingernail plates with concave profiles (Fig. 3), and dark brown or even blackish colored toenails. Both the mother and maternal grandmother acknowledged that their nails were abnormal from early childhood. Repeated microscopic examination and culture of fungi from both fingernails and toenails were negative. Several distal portions of the nail plates were collected for histologic examination. The fingernail plates of the boy's mother showed numerous parakeratotic cells in the middle zone, and those of his maternal grandmother showed diffuse parakeratotic cells; melanin granules were not found in those nail plates that were checked. Taken together, a diagnosis of familial koilonychia was established.The boy's mother has concave fingernail plates with brown colored distal halvesimageThe boy's maternal grandmother has concave fingernail plates with a dark brown colorimage
Metastatic cutaneous leiomyosarcoma from primary neoplasm of the mesentery
Authors: Kim Kyoung Jin , Lee Won Sin , Chang Sung Eun , Choi Jee Ho , Sung Kyung Jeh , Moon Kee Chan , Koh Jai Kyoung 
Published: March 2003

A 31‐year‐old South Korean woman was referred to the dermatology department from the oncology department for the evaluation of a subcutaneous nodular lesion on the back. Three years before, she noted a palpable, fingertip‐sized, nontender mass on her right lower abdomen. The mass had increased in size slowly. One year ago, she visited a local clinic and physical examination revealed a 7 × 8 × 7 cm, slightly tender, deep‐seated mass on the right lower quadrant of the abdomen. The mass on the ilial mesentery was resected by surgical exploration and tissue examination revealed leiomyosarcoma. She refused adjuvant chemotherapy.Approximately 3 months later, she re‐visited the clinic with a tender, subcutaneous nodule on the back. Cutaneous examination revealed a solitary, 2 × 2 cm, well‐defined, hard, movable, subcutaneous nodule on the upper back without skin color change (Fig. 1). She complained of tenderness on touching the lesion. Histologic examination of a biopsy specimen showed irregularly arranged spindle cells scattered throughout the dermis. They were arranged in haphazardly oriented or interweaving fascicles. Most of the spindle cells possessed elongated nuclei with blunt ends and some cells had a polygonal outline with irregularly shaped nuclei (Fig. 2). There were many mitoses: 3–4 per high‐power (× 400) field. Immunohistochemically, smooth muscle actin and desmin were positive in most of the tumor cells (Fig. 3). S‐100 reactivity was not observed. A diagnosis of metastatic leiomyosarcoma was made. About 1 month later, computed tomography showed two, ill‐defined, heterogeneous, low attenuation masses in the right lobe of the liver, suggesting liver metastasis. The patient was treated with chemotherapy for 2 months and remains in good condition.2 × 2 cm, solitary, well‐defined, hard, movable, subcutaneous nodule without any overlying skin changeimage(a) Characteristic findings of cutaneous leiomyosarcoma with markedly high cellularity and densely packed transverse and longitudinal fascicles of cells (hematoxylin and eosin, × 40). (b) High magnification of the neoplasm revealing spindle cells with blunt‐ended nuclei, pleomorphism, and mitotic figures (hematoxylin and eosin, × 200)imageimageDense cytoplasmic reactivity for smooth muscle actin is apparent (smooth muscle actin, × 200)image
Three cases of cutaneous sparganosis
Authors: Kim Soo Hong , Park Kyungho , Lee Eil Soo 
Published: March 2003

Case 1 A 64‐year‐old man visited our clinic complaining of an asymptomatic nodule on his right thigh, detected 10 days previously. Physical examination revealed a solitary subcutaneous nodule, 1.5 cm in diameter on his right thigh. Twenty years previously the patient had undergone surgery to remove a ‘‘worm’' from his leg. The patient stated that he enjoyed eating raw snakes. On performing excisional biopsy of the lesion, the white, flat, shiny sparganum was detected and removed (Fig. la). The histopathological study of the biopsy specimen showed several encapsulated, mummified sparganum pieces and dense lymphohistiocytic infiltration along with neutrophils and eosinophils (Fig. lb).(a) A flat, band‐like, white glistening sparganum being removed from the right thigh of case 1. (b) An encapsulated, mummified sparganum piece showing degenerated internal organs (hematoxylin and eosin × 40)imageimage Case 2 A 53‐year‐old woman was noted to have an asymptomatic nodule on her inguinal area for over 3 years. Although the lesion was asymptomatic the patient dubiously described the lesion as creeping upward in a linear pattern at negligible speed. The patient denied ingesting snakes or any kind of exotic food, yet admitted to drinking from springs occasionally as she climbed mountains. On physical examination, a relatively ill‐defined soft nodule was detected on her left inguinal area. While performing excisional biopsy of the lesion, an 8 cm sized white, flat sparganum was noticed and removed (Fig. 2). The histopathological study revealed a panniculitis infiltrated with eosinophil and lymphohistiocytes.An 8‐cm white, flat larva from case 2image Case 3 A 41‐year‐old man presented with an asymptomatic nodule on his right thigh detected 3 years previously. The patient had eaten raw snakes about 10 years earlier. The clinical feature of the lesion was a solitary pea‐sized nodule without any change in color on overlying skin. The biopsy from the lesion disclosed fragments of a larval cestode with morphologic features of sparganum (Fig. 3).Cross section of Sparganum, shows tegument (T), numerous smooth muscle fibers (M), excretory ducts (E) and calcareous bodies (C) (hematoxylin and eosin × 100)image