bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eccrine syringosquamous metaplasia
Authors: Darouti Mohammad A. El , Marzouk Salonas A. , Hadidi Heba A. Ei , Sobhi Rehab M. 
Published: March 2003

A 7 year‐old male child presented with erythematous erosive plaques affecting the upper and lower eyelids of the left eye and extending to the cheek. Crustations over the right nostril were also evident. His general health status was normal. His medical history revealed that he was suffering from chronic myeloid leukemia for which he was receiving cyclic pulse therapy of cytarabine, doxorubicin and prednisone.It was noticed that the skin eruption was activated after each cycle and faded in 2–3 weeks to reappear after the next cycle but it never really cleared completely. The clinical differential diagnosis included herpes simplex, contact dermatitis, neutrophilic eccrine hidradenitis (NEH) and atypical fungal infection.The investigations included a complete blood count which showed a picture of improving leukemia with a total leucocytic count of 60 000/cc, RBCs count 3.7 × 106/cc, and platelet count of 110 000/cc. His hemoglobin was 9% The differential leucocytic count was as follows: basophils 0; eosinophils 4; blast cells 0; promyelocytes 0; myelocytes 10; juvenile cells 7; staff cells 14; segmented 45; lymphocytes 18 and monocytes 2.Cultures for fungi were negative, and serological examination for HIV, herpes simplex (IgG and IgM) cytomegalovirus and Epstein‐Barr virus antibodies were within normal ranges.Examination of a skin biopsy taken from the periorbital lesions revealed the presence of numerous islands of squamous cells extending from the epidermis into the upper‐ and mid‐dermis. Some of the islands were typically present around sweat ducts. On higher magnification, the cells forming the islands and lining the ducts were found to have abundant eosinophilic cytoplasm and large pale nuclei with prominent nucleoli. Some of the cells were dyskeratotic and there were occasional mitotic figures. Sparse lymphoid cell infiltrate was found surrounding some of the squamous cell islands.Based on the findings of squamous metaplasia of the cells lining the sweat ducts as well as the resemblance of some islands to squamous cell carcinoma, the diagnosis of eccrine syringosquamous metaplasia was made.Apart from the use of topical antibiotic creams, the patient received no therapy for his condition. Spontaneous improvement occured within 18 days after initial presentation but it recurred after the next cycle of chemotherapy.
Immunochemotherapy for cutaneous leishmaniasis: a controlled trial using killed Leishmania (Leishmania) amazonensis vaccine plus antimonial
Authors: Machado‐Pinto Jackson , Pinto Jorge , Da Costa Carlos Alberto , Genaro Odair , Marques Marcos José , Modabber Farrokh , Mayrink Wilson 
Published: March 2003

AbstractBackground Leishmaniasis is endemic in 88 countries in the world, and 350 million individuals are at risk of acquiring the disease. Treatment for American cutaneous leishmaniasis (ACL) is long, expensive, and associated with important side‐effects.Methods In this double‐blind, placebo‐controlled study, we treated 102 patients with ACL using either a combination of a single‐strain Leishmania amazonensis killed promastigote vaccine plus a half dose of meglumine antimoniate, or placebo plus the same half dose regimen of meglumine antimoniate, in 10‐day series followed by 10‐day intervals.Results Of the 47 patients in the experimental arm, 47 (100%) were cured after four series of treatment, compared to four of 49 (8.2%) in the control group (P < 0.0001). Six patients were lost to follow‐up.Conclusions The combination of a single‐strain Leishmania (Leishmania) amazonensis killed promastigote vaccine with a half dose regimen of antimonial is highly effective for the treatment of ACL.
Treatment of cutaneous T‐cell lymphoma with alitretinoin gel
Authors: Bassiri‐Tehrani Shirley , B.A.  , Cohen David E. 
Published: March 2003

A 62‐year‐old man with a 5‐year history of tumor stage cutaneous T‐cell lymphoma (CTCL) used alitretinoin gel, 0.1% twice daily on a right sole tumor. The treatment at the time of topical therapy included acitretin, 35 mg daily, and psoralen with ultraviolet A radiation (PUVA) twice weekly. Previous therapy included topical mechlorethamine, etretinate, and topical glucocorticoids. After 6 weeks, he discontinued alitretinoin gel upon noting that the treated tumor site had turned black. Two weeks later (2 months after the initiation of therapy) he presented with a 6‐cm keratotic plaque on the treated area with a 1‐cm eschar. No lymphadenopathy, peripheral erythema, or tenderness was noted. He started amoxicillin/clavulanate, 875 mg twice daily, and 2% mupirocin ointment. One month later, the foot lesion had completely eroded into a 6‐cm plaque (Fig. 1). There were no changes in the tumors on his trunk, face, and extremities.Foot lesion eroded into a 6‐cm plaque.imageA biopsy of the eroded lesion revealed a diffuse dermal, predominantly lymphocytic, infiltrate with histiocytes, eosinophils, and plasma cells. The morphologic features were suspicious for CTCL; however, immunophenotyping and immunogenotyping failed to detect a T‐cell receptor gene rearrangement, precluding a diagnosis of CTCL. Over the next 6 months, the ulcer re‐epithelialized and completely resolved. Eight months later, acitretin and PUVA were discontinued because of new tumor formation. Oral bexarotene and intravenous methotrexate with leucovorin rescue were initiated with stabilization of tumor growth. The right sole lesion has not recurred up to 20 months after treatment.
Two Japanese cases of localized involutional lipoatrophy
Authors: Hisamichi Katsuya , Suga Yasushi , Hashimoto Yukiko , Matsuba Shouichi , Mizoguchi Masayuki , Ogawa Hideoki 
Published: March 2003

We present two Japanese cases of involutional lipoatrophy. The first case is that of a 30‐year‐old woman, who first appeared at our hospital complaining of a localized, well‐demarcated depression, approximately 3 × 4 cm in size, normal to slightly erythematous in coloration, on the lateral side of the left upper arm (Fig. 1a). The condition was asymptomatic, and she had noticed this anomaly a month prior to consultation. She received intramuscular injections of corticosteroids of unknown dosage at the affected site for the treatment of allergic rhinitis 4 months prior to her present consultation.Clinical, histological and immunohistological findings in two cases of localized involutional lipoatrophy. Loss of subcutaneous tissue in the left upper arm is seen both in the first (a) and second (b) cases. Arrowheads indicate the depressed region. (c) The involved regions showed a decrease in the size of individual lipocytes in the first case (bar = 10 µm). (d) Immunoperoxidase staining for CD68 in the first case. Scattered macrophages (arrowheads) were identified within the affected adipose tissue and surrounding connective tissue (bar = 10 µm)imageThe second patient, a 23‐year‐old woman, appeared at our hospital complaining of a similar macule 4 × 4 cm in size, which she noticed several weeks prior to her most recent consultation. She had no history of injury or injection at the site before the development of the condition (Fig. 1b). She had been under treatment for atopic dermatitis since early childhood and was treated only with topical applications of white petrolatum containing 2% salicylic acid for the past several years.In order to rule out the possibility of acquired partial lipodystrophy associated with localized scleroderma, lupus profundus and the other connective tissue diseases, a histological examination was performed for both patients. Histopathological analysis of the region exhibited a well‐defined fat lobule composed of numerous small adipocytes (Fig. 1c) embedded in hyaline connective tissue. Edema and dilated capillaries were noticeable in the subcutaneous tissue surrounding the area. Inflammatory cells were not prominent, although mononuclear cells were observed in both patients. No epidermal change was seen in either patient.Direct and indirect immunofluorescence studies revealed no deposits of immunoreactants in the skin of either patient. Immunohistochemical studies with the antibody against macrophage (anti‐CD68 antigen; DAKO.) showed that positive cells were scattered around blood vessels and shrunken lipocytes in the subcutaneous tissues (Fig. 1d). Most of these cells in the fat lobules were also positive for mucin stains such as Alcian blue.No abnormal findings came to light in the ordinary hematological and blood chemistry examinations of both patients. The autoantibody screening tests using antinuclear, anti‐DNA, anticentromere, and anti‐Scl‐70 antibodies were negative in both patients.
Exercise‐induced anaphylaxis in a marathon runner
Authors: Adams Brian B. 
Published: March 2003

After completion of a marathon (26.2 mile running race), a 41‐year‐old woman presented to the medical tent complaining of hand swelling. She denied any hand pain or numbness, diarrhea, nausea, vomiting, or abdominal pain, but admitted to slight hoarseness. Whilst she denied shortness of breath at that moment, she had noted dyspnea out of proportion to her athletic activity during the first 3 miles of the marathon. Thereafter, she ran without respiratory discomfort.She also recalled hand swelling and dyspnea out of proportion to her activity during her marathon training, especially on warm and humid days. Similar lesions, but to a much milder degree, had developed during brisk walks. These lesions began within the first 15 min of exercise and were associated with pruritus. She admitted to eating, only occasionally, a banana before her runs. She denied developing lesions whilst experiencing sudden powerful emotions, taking hot showers, or eating hot foods. She had no other medical problems, except for depression, for which she took venlafaxine. The symptoms related to her running were unrelated to her venlafaxine intake. She began having the swelling many years before starting the medication and continued having the swelling after discontinuation of venlafaxine. She had no history of atopic dermatitis, but 2 years subsequent to this most recent episode, she had been diagnosed with atopic dermatitis by her primary medical physician. There was no family history of similar eruptions.Physical examination revealed diffuse swelling of both hands, including all digits, with mild, ill‐defined overlying erythema (Fig. 1). She had similar lesions on her feet and also had mild diffuse facial swelling, but did not have pronounced lip, tongue, or eyelid swelling. The swelling largely resolved within 4 h.Diffuse swelling involving the hand and all digits with mild overlying erythema. Notice the constriction of the digit caused by the runner's wedding ringimageExercise‐induced anaphylaxis was diagnosed. The patient continues to have similar eruptions with exercise, but has refused treatment with antihistamines or epinephrine.
Stop female genital mutilation: appeal to the international dermatologic community
Authors: Morrone Aldo , Hercogova Jana , Lotti Torello 
Published: March 2003

AbstractFemale genital mutilation (FGM) is a traditional cultural practice, but also a form of violence against girls, which affects their lives as adult women. FGM comprises a wide range of procedures: the excision of the prepuce; the partial or total excision of the clitoris (clitoridectomy) and labia; or the stitching and narrowing of the vaginal orifice (infibulation).The number of girls and women who have been subjected to FGM is estimated at around 137 million worldwide and 2 million girls per year are considered at risk. Most females who have undergone mutilation live in 28 African countries.Globalization and international migration have brought an increased presence of circumcised women in Europe and developed countries. Healthcare specialists need to be made aware and trained in the physical, psychosexual, and cultural aspects and effects of FGM and in the response to the needs of genitally mutilated women. Health education programs targeted at immigrant communities should include information on sexuality, FGM, and reproduction. Moreover, healthcare workers should both discourage women from performing FGM on their daughters and receive information on codes of conduct and existing laws. The aim is the total eradication of all forms of FGM.
Childhood lichen planus: a study of 87 cases
Authors: Handa Sanjeev , Sahoo Bijaylaxmi 
Published: March 2003

AbstractAims We undertook this study to analyze the clinical profile of childhood lichen planus (LP) prevailing in north India, and to highlight differences from and similarities with adult LP.Methods Clinical records of children with LP, who attended the Pediatric Dermatology Clinic, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India, from July 1988 to December 2000, were analyzed.Results Eighty‐seven patients with LP were examined during a 12.5‐year period of observation. These patients formed 2.5% of the total number of pediatric dermatology patients and 0.6% of the total number of new dermatology outpatients. The male : female ratio was 1.1 : 1. The age at onset was between 8 months and 12 years (mean, 7.1 years). Classical LP was observed in 53 (60.9%) patients, followed by actinic LP in 10 (11.5%), and lichen planus hypertrophicus (LPH) and linear LP in eight (9.2%) each. Other forms seen were eruptive, follicular, lichen planopilaris, atrophic, and bullous LP. The involvement of skin alone was observed in 75 (86.2%) children and mucosa alone only in one (1.1%) child. Concomitant skin and mucosal involvement was seen at the time of presentation in four patients, while mucosal involvement occurred later during the course of the disease in seven patients. Lesions appeared earlier in boys than in girls.Conclusions The natural history of LP in children was essentially similar to that in adults. Unusual features, such as involvement of the palms and soles and upper eyelids, were observed. Actinic LP, mimicking melasma, as reported in adult women, also seems to occur in children.
An interesting case of colocalization of segmental lichen planus and vitiligo in a 14‐year‐old boy
Authors: Sardana Kabir , Sharma Ravi C. , Koranne R. V. , Mahajan Supriya 
Published: March 2003

A 14‐year‐old boy had segmental vitiligo (L3−4) on the right thigh and leg for 4 years, and was advised to apply topical clobetasol propionate, 0.05%, in the night, with daily sun exposure for 10 min, as he refused to comply with topical psoralens. As there was no response to therapy even after 3 months, the patient stopped the steroid cream but continued with the sun exposure. Subsequently, the patient noticed gradual‐onset, itchy, violaceous, pigmented, raised lesions superimposed on the vitiligo macules. Cutaneous examination revealed violaceous, polygonal papules, 0.5 × 0.5 cm in size, some of which coalesced to form discrete violaceous plaques, confined to areas of vitiligo, with a clear‐cut demarcation from normal skin (Fig. 1). The scalp, palms, soles, nails, and mucosa were normal. Histopathology of the polygonal papules revealed hyperkeratosis, wedge‐shaped hypergranulosis, irregular acanthosis with saw toothing of the rete ridges, basal cell liquefaction, and a band‐like lymphocytic infiltrate (Fig. 2), consistent with lichen planus. The patient was subsequently prescribed fluticasone propionate (0.05%) ointment once daily for the lesions of lichen planus. There was a marked improvement in the lesions of lichen planus after 1 month.Violaceous papules of lichen planus colocalized on vitiligo macules with associated leukotrichia seen on the right legimageHistopathology reveals hyperkeratosis, wedge‐shaped hypergranulosis, irregular acanthosis with saw toothing of the rete ridges, basal cell liquefaction, and a band‐like lymphocytic infiltrate (hematoxylin and eosin, × 40)image
Polymyositis and dermatomyositis associated with malignancy: a 30‐year retrospective study
Authors: Wakata Nobuo , Kurihara Teruyuki , Saito Eizo , Kinoshita Masao 
Published: March 2003

AbstractBackground Polymyositis and dermatomyositis in association with malignancy are paraneoplastic syndromes, but the incidence, treatment and factors that predict associated cancer and its prognosis all remain unclear.Patients and Method During the 30‐year period 1969–99, we treated 64 patients who had polymyositis (including two with cancer) and 28 patients who had dermatomyositis (including 10 with cancer). We compared the clinical findings of the patients who had cancer with the findings of those who did not have cancer.Results The risk of cancer is significantly higher in dermatomyositis and somewhat higher in polymyositis. An increased cancer risk was found in male patients with dermatomyositis who were older than 50 years. Cancer was diagnosed within 4 years before or after the diagnosis of polymyositis or dermatomyositis, and usually within 1 year. An operation was not possible in many of the patients with cancer because of the advanced stage of the disease.Conclusion Our findings suggest that early discovery of malignancy is critical in cases of polymyositis and dermatomyositis.
Microsatellite assessment of multiple paternity in natural populations of a live-bearing fish, Gambusia holbrooki
Authors: Zane  , Nelson  , Jones  , Avise  
Published: March 2003

Abstract
Three polymorphic microsatellite loci were isolated and employed to examine paternity patterns in two natural populations of live-bearing mosquitofish, Gambusia holbrooki. Each locus displayed four to five alleles per population in samples of presumably unrelated adults. Nearly 900 embryos from a total of 50 pregnant females were assayed individually, and paternal alleles in each embryo were identified. Counts of paternal alleles, Mendelian segregation patterns, multilocus allelic associations and genetic relatedness coefficients were employed to estimate the minimum and effective numbers of fathers per brood. At least 90% of the assayed broods were shown to have been fathered by multiple males, a figure substantially higher than previous estimates based on less polymorphic genetic loci. However, the genetic data yield a face-value estimate of only about 2.2 fathers per brood, a number that seems perhaps surprisingly low based on frequencies of attempted copulations by males. Both biological and sampling factors that might bias mean sire counts downward are considered. Although higher sire counts per brood might be obtained from loci with even greater numbers of alleles, little statistical room remains for higher frequency estimates of multiple paternity in Gambusia.
The costs of sex due to deleterious intracellular parasites
Authors: Hastings  
Published: March 2003

Abstract
A major problem in evolutionary theory is to explain the widespread occurrence of sexual recombination. This is particularly difficult in anisogamous species where the familiar ‘two-fold cost of sex’ is encountered. Another cost has recently been identified: that fusion of gametes allows intracellular parasites or deleterious ‘selfish’ genomes to invade a population. These costs of anisogamy and the ability of cytoplasmic agents to invade a sexual population are quantified, allowing the costs and consequences of different modes of reproduction to be compared. It is found that the costs of selfish elements are likely to be very high and, in particular, that isogamous sexual reproduction (the putative ‘primitive’ form) is not cost-free, but incurs a fitness reduction of the order of 90%; thus a large selective disadvantage occurs in the initial evolution of sex which is ignored in standard analysis. Even once anisogamy has evolved, the low levels of ‘paternal leakage’ observed in many extant organisms may allow selfish cytoplasmic elements to spread, resulting in moderate to large decreases in host population fitness. However, much of the cost of selfish elements is avoided in sexual lifecycles with a large number of asexual cellular divisions between sexual reproduction: this greatly impedes the spread of selfish agents and reduces the fitness loss attributable to selfish elements.
Evidence for effects of restorer genes on male and female reproductive functions of hermaphrodites in the gynodioecious species Thymus vulgaris L.
Authors: Gigord  , Lavigne  , Shykoff  , Atlan  
Published: March 2003

Abstract
In Thymus vulgaris L., sex determination involves both the nuclear and the cytoplasmic genomes: the cytoplasm is responsible for male-sterility (the female phenotype) while specific nuclear genes may restore male fertility (the hermaphrodite phenotype). Previous observations have shown high variation among hermaphrodites for pollen and seed production. In order to investigate the origin of this variation, 12 female plants, four from each of three populations, were hand-pollinated with pollen from hermaphrodites from three different paternal populations. The sex-ratio (i.e. the frequency of hermaphrodites) produced and the reproductive functions of these offspring were measured. A strong positive correlation was observed between the sex-ratio within a family and both female and male reproductive functions of its hermaphrodites. No such correlation was found for females. This result suggests that restorer genes may be directly or indirectly involved both in sex determination and in the efficiency of resource allocation to reproductive functions. As a consequence, female advantage, i.e. the relative fecundity of females to hermaphrodites, is larger in families with low sex-ratio, and this might affect the evolution of this gynodioecious breeding system.
Accuracy and power in fluctuating asymmetry studies: effects of sample size and number of within-subject repeats
Authors: Dongen S. Van 
Published: March 2003

Abstract
This paper presents results from simulations investigating the effect of sample size, number of within-subject repeats and relative degree of measurement error on the power and accuracy of test for fluctuating asymmetry (FA). These data confirm that sampling variation of population-level FA-estimates is large and that high sample size is required to obtain reasonably high power when testing for FA or comparing FA levels between populations. The results also clearly show that increasing the number of within-subject repeats can dramatically increase accuracy and power when measurement error is relatively high.