bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lupus vulgaris complicated by metastatic squamous cell carcinoma
Authors: Yerushalmi Joseph , Grunwald Marcelo H. , Halevy Dafna Hallel , Avinoach Ilana , Halevy Sima 
Published: March 2003

A 47‐year‐old Bedouin man presented with an ulcerated nodule of several months’ duration on the nape of the neck. The nodule developed on an asymptomatic, slowly growing plaque which appeared during childhood. Physical examination revealed two erythematous plaques covering the posterior and right lateral aspects of the neck. The border of the plaques was soft, circinate, with a reddish‐brown color, while the center was slightly erythematous and atrophic. An ulcerated nodule measuring 2 cm was seen on one of the plaques (Fig. 1). Physical examination was unremarkable with no lymphadenopathy. Laboratory tests, including complete blood cell count, erythrocyte sedimentation rate (ESR), and routine chemistry tests, were all within normal limits. Chest X‐ray showed a small calcified perihilar lymph node. The Mantoux test was positive with erythema and induration of 15 mm after 48 h. Biopsy from a plaque showed extensive diffuse granulomatous infiltration throughout the dermis with epithelioid and Langhans giant cells surrounded by mononuclear inflammatory cells. No caseation necrosis was present. Ziehl–Neelsen, periodic acid–Schiff (PAS), and Giemsa stains were negative. Polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis and atypical mycobacteria from a skin sample was also negative. Fresh tissue cultures yielded M. tuberculosis after 6 weeks.Ulcerated nodule on the atrophic plaqueimageA biopsy specimen from the ulcerated nodule demonstrated islands of atypical malignant squamous cells invading the dermis, which were compatible with moderately differentiated squamous cell carcinoma (SCC) (Fig. 2). The ulcerated nodule was completely excised, and treatment for tuberculosis was initiated with a combination of isoniazid, rifampicin, and pyrazinamide. Within 3 months of therapy, the patient's lesions resolved, leaving only slightly atrophic hypopigmented scars. A month after the treatment's initiation, an enlarged cervical lymph node was noted showing metastatic SCC on histologic examination. The patient underwent neck dissection and radiation therapy without evidence of any further metastases.Moderately differentiated squamous cell carcinoma appearing in the ulcerated cutaneous granulomatous lesion (hematoxylin and eosin stain; original magnification, ×400)imageDiscussion
Characteristics of bacterial skin infections in children compared to adults at a tertiary dermatologic center
Authors: Sugeng Maria W. , Ang Por , Tan Hiok Hee , Goh Chee Leok , Centre From the National Skin , Singapore . 
Published: March 2003

AbstractBackground Bacterial skin infections in children and adults are caused by different organisms with different antimicrobial susceptibility.Methods A comparative retrospective study was carried out on 233 adults and 53 children with bacterial skin infections. Skin swab cultures and sensitivity tests were performed using standard methods. Statistical analysis was performed using the Pearson chi‐squared and Fisher tests. A P value of <0.05 was considered to be significant.Results Primary and secondary skin infections occurred in equal proportions in children, whereas secondary skin infections were more common in adults (70.8%). Staphylococcus aureus was the main cause of skin infections, particularly in children (72.6%). S. aureus in children and adults was highly susceptible to cloxacillin, cephalexin, chloramphenicol, neomycin, cotrimoxazole, and clindamycin, moderately susceptible to erythromycin, and insensitive to tetracycline, ampicillin, and penicillin.Conclusions It is important to monitor the trends of bacterial infections and their antibiotic susceptibility as this can assist medical practitioners in their choice of antimicrobial therapy. Such monitoring will also help to detect the emergence of resistant bacterial strains and caution us to take care in the use of certain drugs.
Quantitative analysis of nailfold capillary abnormalities in patients with connective tissue diseases
Authors: Ohtsuka Tsutomu 
Published: March 2003

AbstractBackgroundNailfold capillary microscopy has been shown to reflect microvascular disturbances mainly in connective tissue diseases including systemic sclerosis (SSc).MethodsNailfold capillary abnormalities were analyzed with a light microscope under immersion oil at magnifications of ×60 and ×400.ResultsAbnormal nailfold capillary pattern in SSc was different from that of systemic lupus erythematosus (SLE) and normal controls, but not from dermatomyositis (DM). Seventy‐two per cent of patients with Raynaud’s phenomenon showed an abnormal nailfold capillary pattern. In primary Raynaud’s phenomenon, 12% of subjects developed undifferentiated connective tissue disease. In undifferentiated connective tissue disease, 23% developed SSc. The apical limb width, capillary width and capillary length of subjects who developed SSc were significantly larger than in those who did not. With regard to the clinicolaboratory findings, the occurrence rate of an abnormal apical limb width, abnormal capillary width, abnormal capillary length, and antinuclear antibody in patients who developed SSc was significantly higher than in those who did not. An abnormal capillary pattern correlated with an elevated pulmonary artery resistance. All the patients with pulmonary arterial hypertension showed an abnormal capillary pattern, decreased diffusion capacity for carbon monoxide, and elevated pulmonary vascular resistance. Nailfold capillary abnormalities show a close relation to pulmonary arterial hypertension.ConclusionsNailfold capillary abnormalities are useful for detecting vascular abnormality in clinical practice. These facts stress the importance of nailfold capillary abnormalities in SSc.
Ocular toxicity of chloroquine among Thai patients
Authors: Puavilai Siripen , Kunavisarut Skowrat , Vatanasuk Mongkol , Timpatanapong Penwadee , Sriwong Suwitcha T. , Janwitayanujit Suchela , Nantiruj Kanokrat , Totemchokchyakarn Kitti , Ruangkanchanasetr Suwanna 
Published: March 2003

Abstract Background Chloroquine has been prescribed for the treatment of various diseases. The most serious side‐effect of chloroquine is retinopathy. The frequency of occurrence of retinopathy varies from 0.001 to 40% depending on the criteria used. The purpose of this study was to evaluate the incidence of ocular toxicity from chloroquine treatment among Thai patients. Methods A retrospective study was carried out in patients treated with chloroquine at Ramathibodi Hospital over the past 10 years (1987–1997). Patients eligible for review were followed by ophthalmic examination by an ophthalmologist for at least 6 months after starting treatment. Results One hundred and fifty‐five patients were studied. Nineteen were men and 136 were women. They ranged in age from 10 to 70 years. Most patients received 250 mg of chloroquine per day. The duration of treatment varied from 6 months to 14 years, and the cumulative dose of chloroquine ranged from 26 to 1771 g. Fourteen patients (9%) had only corneal deposition, while 22 (14.2%) developed retinopathy. There were no correlations between corneal deposits or retinopathy and age, sex, duration of treatment, or cumulative dose of chloroquine. Conclusions The present study confirms the finding reported by Mackenzie (Am J Med 1983; 75 (Suppl 1A): 40–45) that retinopathy is not related to the duration of treatment and cumulative dose of chloroquine. Based on our finding that retinopathy can be detected as early as 9 months after starting chloroquine therapy, we recommend routine ophthalmic examination before treatment and every 6 months thereafter.
Fatal cutaneous necrosis in a hemodialyzed patient with oxalosis
Authors: Galimberti Ricardo Luis , Parra Isabel Hidalgo , Imperiali Nora , Diez Guillermo Rosa , Kowalczuk Alicia , Algranati Luis , Galimberti Gaston 
Published: March 2003

A 49‐year‐old woman had a history of recurrent nephrolithiasis and urinary infections since childhood that resulted in end‐stage renal disease. She had been receiving hemodialysis for 4 years. Four months before her admission to hospital, she was to have undergone a bilateral nephrectomy but, during anesthesia induction, she suffered a cardiac arrest and the operation was interrupted. Shortly thereafter she developed skin lesions.Clinical features included bilateral livedo reticularis and painful violaceous plaques with necrotic changes in both legs, with some blisters on the left leg ( Fig. 1). Skin biopsy showed arterial occlusion with calcium salt deposits with von Kossa reaction, necrosis of the small vessels, and epithelial necrosis
(
Fig. 2). A crystallographic study of the skin was performed showing 100% calcium oxalate crystals (wedellita).Necrotic and ulcerated plaque with blisters on the skin on the left legimagevon Kossa‐stained tissue revealed calcium deposits in blood vessels ( × 40)imageLaboratory tests revealed a hematocrit of 27%, increased calcium/phosphate (Ca 9.8 meq/L; phosphate 14.9 meq/L), blood urea 159 mg/dL, creatinine 9.1 mg/dL, albumin 1.92 mg/dL, serum uric acid 11 mg/dL, diabetes (serum glucose 148 mg/dL), and hyperparathyroidism (serum parathormone 150 pg/mL).X‐Ray of the hands showed soft tissue calcium deposits. X‐Ray of the legs showed signs of bone resorption: subperiosteal erosions in phalangeal bones, vascular calcifications. Bone biopsy showed massive oxalate crystal deposits.She underwent a parathyroidectomy. Unfortunately, she suffered a terminal cardiac arrest in the immediate postoperative period.
Pattern of skin diseases among pilgrims during Hajj season in Makkah, Saudi Arabia
Authors: Fatani Mohamad Ibrahim , Al‐Afif Khalid Abdullah , Hussain Hameed 
Published: March 2003

Abstract Background Skin diseases among pilgrims are considered to be one of the possible health problems in our area. Data supporting this observation are scanty and sparse. The aim of this study was to report the most common skin diseases seen in a 15‐day period. Methods We retrospectively collected all new cases of skin diseases diagnosed during a 15‐day period at King Faisal Hospital, the nearest general medical center to Mina. Pilgrims gather at Mina (which harbors more than two million pilgrims every year) to perform their Hajj. Results During the Hajj season in 1998, 731 new patients were seen; 63.3% were men and 36.7% were women. Of these cases, Saudi citizens represented 42.5% of the total patients. The peak age group ranged from 20 to 39 years. The incidence in Saudi patients was more than that in other nationalities. Dermatitis of various etiologies (23.6%) was found to be the most common skin disease. Pyoderma was found to be more common in Saudis and Asians than in Arabs, whereas Arabs suffered from intertrigo much more than Asians and Saudis. Conclusions A high incidence of skin diseases such as pyoderma and intertrigo among pilgrims of such a large congregation is understandable. Investigating these skin infections is worthwhile because they are preventable, easily diagnosed, and are curable in the majority of patients.
Clinical evaluation of a more rapid and sensitive Psoriasis Assessment Severity Score (PASS), and its comparison with the classic method of Psoriasis Area and Severity Index (PASI), before and after climatotherapy at the Dead‐Sea
Authors: Harari Marco , Shani Jashovam , Hristakieva Eugenia , Stanimirovic Andrija , Seidl Wladimir , Burdo Asia 
Published: March 2003

Abstract Background  The Psoriasis Area and Severity Index (PASI) is used to quantify the extent of the disease, and to evaluate its improvement with treatment. It is considered to be a slow, rough, nonsensitive, and complex tool, with high interobserver variability and low reproducibility.Objectives and methods  To develop a simpler, more sensitive, and more rapid end‐point determination for evaluating the psoriatic condition, and to compare its sensitivity with that of the classic PASI score in psoriatic patients undergoing 4‐week climatotherapy at the Dead‐Sea (Israel).Results  This study describes a new, rapid, and simple Psoriasis Assessment Severity Score (PASS), whose readings are spread over a longer scale, making the test more sensitive than PASI, and allow better differentiation.Conclusions  The comparison between the classic PASI and our new PASS emphasizes the weight of the ‘‘sensitivity to change’' (responsivity) in selecting a better evaluation method for psoriatic patients.
Delayed cutaneous reaction to jellyfish
Authors: Veraldi Stefano , Carrera Carlo 
Published: March 2003

A 57‐year‐old woman presented with a widespread papulonodular eruption. The dermatitis had appeared about 1 week after her return from a trip to the Red Sea, where she had come into contact with a shoal of unidentified jellyfish; however, that contact had not been followed by cutaneous lesions and/or symptoms. The patient also stated that she had had previous contacts with jellyfish during other trips to exotic seaside resorts.The dermatitis was characterized by papulonodular lesions, round or oval in shape, of a few millimeters in diameter, with a color ranging from pink to red to brown, and with a smooth and regular surface. The lesions were grouped in an apparently random fashion ( Fig. 1) or arranged linearly (
Fig. 2). The patient complained of pruritus and burning.Grouped papulonodular lesionsimagePapulonodular lesions linearly arrangedimageHistopathologic examination showed the presence of some necrotic keratinocytes; in the upper and mid dermis, edema and a predominantly perivascular and periadnexal lymphohistiocytic infiltrate, with numerous neutrophils and eosinophils, were observed ( Fig. 3).Epidermal erosion, covered by a crust, at the center of the lesion. Dermoepidermal detachment, edema, and lymphohistiocytic infiltrate, with numerous neutrophils and eosinophils in the upper and mid dermis (hematoxylin and eosin, ×12.5)imageThe patient was treated with hydroxyzine (37.5 mg/day) and hydrocortisone butyrate, which resulted in the rapid disappearance of the symptoms; however, the cutaneous lesions persisted for about 3 weeks.
Cytodiagnosis of cutaneous basal and squamous cell carcinoma
Authors: Vega‐Memije Elisa , De Larios Nassira Martinez‐. , Waxtein Leon M. , Dominguez‐Soto Luciano 
Published: March 2003

Abstract Objective We performed a prospective study to evaluate the diagnostic accuracy of cytologic examination in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), in order to assess its clinical value. Study design Samples were taken by the “scraping” technique which involves scraping with a scalpel blade directly over the skin tumor surface, smearing the cells onto several glass slides, and fixing them with “citospray.” The specimens were stained with the Papanicolaou stain. Punch biopsies were taken to confirm the clinical and cytologic impression. Results We collected 45 skin tumors in total, clinically presumed to be either BCC (n = 15) or SCC (n = 30). Imprint cytology demonstrated to be of help in the rapid diagnosis of skin tumors. Conclusions Cytologic examination is easy to perform, saves time, provides a rapid diagnosis, and can be considered, under experienced hands, reliable in the confirmation of malignant skin tumors.Cytology does not give much information about tumor patterns or subtypes which can be related to aggressive behavior and can be very important in further therapeutic decisions. Therefore, histopathologic confirmation is mandatory before any therapeutic maneuver.
Recurrent aphthous stomatitis and smoking
Authors: Tüzün Binnur , Wolf Ronni , Tüzün Yalçin , Serdaroğlu Server 
Published: March 2003

Abstract Background Several studies have reported cigarette smoking to have a beneficial protective effect on recurrent aphthous stomatitis (RAS). In this study, we evaluated once again the incidence of smoking in RAS patients compared with controls. This study differs from most previous ones in that the patients were diagnosed by direct observation of active lesions by a dermatologist. Methods Thirty‐four patients with RAS who were seen at the dermatology clinic during a period of 2 years were compared with 115 outpatients with other skin diseases and 20 healthy hospital personnel who had no history of aphthae, with regard to their smoking habits. Results Among the 34 patients with RAS, 8.8% were active smokers compared with a significantly higher percentage (25.2%) among the control subjects. Conclusions In agreement with others, we found a negative epidemiologic association between smoking and RAS. This finding can be used to clarify the cause and pathogenesis of the disease, and possibly to identify better treatment or preventive options than those currently available.
Indolent Acremonium strictum infection in an immunocompetent patient
Authors: Anadolu Rana , Hilmioğlu Süleyha , Oskay Tuğba , E Boyvat Ayş , Peksari Yavuz , Gürgey Erbak 
Published: March 2003

A 35‐year‐old housewife presented with an 11‐year history of a painless lesion on the right cheek, which had enlarged over the last 2 years. She had no history of travel or trauma. Various topical and systemic antimicrobial and antifungal agents, such as fluconazole, ketoconazole, sulbactam/ampicillin, and mupirocin, had been prescribed, with a probable diagnosis of pyoderma and blastomycosis, without significant benefit. Her medical history was otherwise unremarkable. Dermatologic examination revealed a well‐circumscribed, erythematous, infiltrative, 8 × 10 cm plaque covering the right cheek and a 2 × 3.5 cm vegetative, ulcerated lesion on the chin (Fig. 1). There were no sinus tracts or grains.Erythematous, infiltrative plaque covering the right cheek, and vegetative, ulcerated lesion on the chinimageThe following laboratory test results were within the normal limits: complete blood count, blood biochemistry, urinalysis, immunoglobulins and complement levels, T lymphocyte, CD4 and CD8 cell counts, and response to mitogens. X‐Rays of the chest and maxillar and mandibular bones were normal. Routine bacterial cultures were negative. Skin biopsies and fungal and mycobacterial cultures were taken with a preliminary diagnosis of deep fungal or mycobacterial infection.Dermatopathologic examination revealed irregular epidermal hyperplasia with follicular plugging. A dense nodular lymphohistiocytic infiltrate was observed within the reticular dermis, with many multinucleated giant cells and plasma cells. In higher magnification, even in hematoxylin and eosin sections, large septate hyphae and spores were noticeable. Periodic acid–Schiff stain revealed abundant fungal structures within the giant cells and extracellularly throughout the inflammatory infiltrate (Fig. 2). Lymphocytes were rather sparse in comparison to the large amount of microorganisms within the tissue.Periodic acid–Schiff‐positive hyphae with phialides and yeast‐like phialoconidia (arrow) within the tissue (× 400)imageFungal cultures were performed on Sabouraud's dextrose agar and, within 1 week of incubation, white fungal colonies were observed. On multiple passages at 26 °C, white tufted colonies with a salmon‐colored base had formed (Fig. 3). Native preparations from the cultured colonies revealed septate hyphae, and 90° angled branches, together with phialides decorated with ellipsoidal conidia with rounded edges (Fig. 4). These findings were consistent with Acremonium strictum, a saprophytic fungus.Fungal culture: salmon‐colored base of the coloniesimageLactophenol cotton blue (× 40): 90° branching septate hyphae with ellipsoidal, round‐ended conidiaimageFurther laboratory examinations revealed no systemic involvement. Following the diagnosis of Acremonium infection, amphotericin B therapy and surgical excision of the tumoral lesion were planned, but the patient refused further treatment and failed to respond to our follow‐up attempts.
Smoking effect on skin wrinkling in the aged population
Authors: Aizen Efraim , Gilhar Amos 
Published: March 2003

Abstract Objectives  Smoking causes premature wrinkling and is one of the more potent risk factors for atherosclerosis. The aims of the present study were to verify: (i) whether there is a difference between the wrinkling appearance in aged smokers and the nonsmoking population; and (ii) whether the systemic effects of smoking, such as atherothrombotic disease and cerebrovascular disease, are associated with a more striking appearance of wrinkling.Participants  Eighty volunteers (mean age, 76 years) were included in the study, 40 of whom were smokers and 20 of whom had suffered a stroke.Results  The mean value of the wrinkling score measured for the smokers' group (stroke and nonstroke) was significantly higher than that for the nonsmokers' group (analysis of variance, ANOVA; P < 0.01). There was no significant difference between the smokers who had suffered from stroke and smokers who had not.Conclusion  The study indicated that prominent facial wrinkling was significantly more common among smokers than nonsmokers, not only in the relatively young but also among the aged population.
Topical formic acid puncture technique for the treatment of common warts
Authors: Bhat Ramesh M. , Vidya Krishna , Kamath Ganesh 
Published: March 2003

Abstract Background  Warts are a common chronic skin disorder that can be cosmetically disfiguring and, depending on the location, cause inhibition of function. The presence of dozens of topical and systemic treatments for warts is a testament to the lack of a rapid, simple, uniformly effective, inexpensive, nonscarring, and painless treatment.Aim  The purpose of this study was to determine the efficacy and safety of 85% formic acid application, an inexpensive therapy, for the treatment of warts.Methods  A placebo‐controlled, nonrandomized, open trial was performed in 100 patients with common warts attending Father Muller's Medical College Hospital, Mangalore. Fifty patients received 85% formic acid application and 50 patients received placebo (water) using a topical application/needle puncture technique every other day.Results  Ninety‐two per cent of patients who received formic acid application showed complete disappearance of warts after a 3–4‐week treatment period, compared to 6% in the placebo group.Conclusions  The results show that 85% formic acid application is a safe, economical, and effective alternative in the treatment of common warts with few side‐effects and good compliance. A multicenter trial is needed to examine the efficacy and safety of this treatment.
Expression of bcl‐2 protein in active skin lesions of Behçet's disease
Authors: Senturk Nilgün , Yildiz Levent , Sullu Yuksel , Kandemir Bedri , Turanli Ahmet Yasar 
Published: March 2003

AbstractBackground  Expression of bcl‐2 protein has been shown to play an important role in the pathogenesis of some inflammatory as well as neoplastic disorders. In this study we have investigated the presence of bcl‐2 protein in active skin lesions of Behçet's disease and compared these results with normal skin samples of Behçet's disease (BD) patients and BD unrelated leukocytoclastic vasculitis.Methods  Active skin lesions of 23 Behçet's disease patients, normal skin samples of seven Behçet's disease patients, and archival biopsy specimens of 23 cutaneous leukocytoclastic vasculitis were investigated for the presence of bcl‐2 protein by immunohistochemical methods. Results of staining were assessed semiquantitatively. Chi‐square tests were used for statistical analysis.Results  Expression of bcl‐2 protein were demonstrated in 16 of 23 (69.5%) and 8 of 23 (34.7%) patients with Behçet's disease and leukocytoclastic vasculitis, respectively. There were statistically significant difference between two groups (x2 = 4.27, P < 0.05). None of the normal skin samples of Behçet's disease patients showed bcl‐2 expression.Conclusion  Expression of bcl‐2 protein may play a particular role in the development of skin lesions in Behçet's disease by causing prolonged survival of infiltrating lymphocytes.