bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of an rK39 dipstick rapid test with direct agglutination test and splenic aspiration for the diagnosis of kala‐azar in Sudan
Authors: Veeken Hans , Ritmeijer Koert , Seaman Jill , Davidson Robert 
Published: March 2003

SummaryWe compared an rK39 dipstick rapid test (Amrad ICT, Australia) with a direct agglutination test (DAT) and splenic aspirate for the diagnosis of kala‐azar in 77 patients. The study was carried out under field conditions in an endemic area of north‐east Sudan. The sensitivity of the rK39 test compared with splenic aspiration was 92% (46/50), the specificity 59% (16/27), and the positive predictive value 81% (46/57). Compared with the diagnostic protocol used by Médecins sans Frontières, the sensitivity of the rK39 test was 93% (50/54), the specificity 70% (16/23), and the positive predictive value 88% (50/57). Compared with splenic aspirates, the sensitivity of a DAT with a titre ≥1:400 was 100% (50/50), but its specificity only 55% (15/27) and the positive predictive value was 80% (50/62). Using a DAT titre ≥1:6400, the sensitivity was 84% (42/50), the specificity 85% (23/27) and the positive predictive value 91% (42/46). All four patients with DAT titre ≥1:6400 but negative splenic aspirate were also rK39 positive; we consider these are probably ‘true’ cases of kala‐azar, i.e. false negative aspirates, rather than false DAT and rK39 seropositives. There were no false negative DATs (DAT titre ≤1:400 and aspirate positive), but there were four false negative rK39 tests (rK39 negative and aspirate positive). The rK39 dipstick is a good screening test for kala‐azar; but further development is required before it can replace the DAT as a diagnostic test in endemic areas of the Sudan.
Intradermal skin test reactivity to histamine and substance P is blunted in dogs with atopic dermatitis
Authors: Marsella Rosanna , Nicklin Constance F. 
Published: March 2003

AbstractSkin reactivity to intradermal injections (0.1, 0.5 and 1 nm) of substance P (SP) was evaluated in 20 clinically normal dogs and 20 dogs with atopic dermatitis (AD). Saline and histamine were used as negative and positive controls, respectively. Wheal diameters were measured. Reactions were evaluated for erythema and induration and a subjective score, on a scale from 0 to 4+, was given. Evaluations were performed at 3, 5, 10, 15 and 30 min after the injections. Wheal diameters for histamine and SP injections were significantly smaller in dogs with AD compared with clinically normal dogs. In both groups, reactions to the various concentrations of SP were not significantly different from each other and were always smaller than histamine reactions. Erythema was not seen with SP injections. In addition, subjective scores for SP injections were significantly lower in dogs with AD compared with controls. The results of this study are similar to those reported in human medicine, where a role for SP in AD is proposed and desensitization of receptors to both SP and histamine is hypothesized. Further studies are needed to investigate the role of SP in the pathogenesis of canine AD.
Severe alopecia areata treated with systemic corticosteroids
Authors: Alabdulkareem Adnan S. , Abahussein Abdulaziz A. , Okoro Anezi 
Published: March 2003

Abstract Background Treatment of severe alopecia areata is difficult, and most efforts to successfully treat this condition have been disappointing. Systemic corticosteroids have been demonstrated as an effective treatment of severe alopecia areata. Methods Eighteen patients with alopecia areata (extensive patchy and totalis universalis types) were treated with systemic corticosteroids. Results Satisfactory hair regrowth was achieved in seven patients (38.9%). Hair fall subsequently occurred in all of these patients on discontinuation or tapering of corticosteroid therapy. Conclusions Systemic corticosteroid therapy does not prevent the spread or relapse of severe alopecia areata and, when complete regrowth is obtained, it is rarely maintained off therapy.
Correspondence
Authors: Goihman‐Yahr Mauricio 
Published: March 2003

A 33‐year‐old woman presented with several subcutaneous nodules of 1 month duration partially coalescing into plaques on her forearms. She had been suffering from Cushing's disease due to a pituitary microadenoma, which had been diagnosed and treated by trans‐sphenoidal surgery 3 months previously. She was taking cortisone acetate, 37.5 mg orally each day, for post‐hypophysectomy hypocorticism. The subcutaneous lesions varied in size from 1 to 6 cm and were flesh‐colored, movable at palpation, and painless.Light microscopy of both nodular and plaque‐like lesions revealed multiple subcutaneous aggregations of histiocytes with several multinucleated giant cells and lymphocytes ( Fig. 1). Special stains for acid‐fast bacilli and fungi and examination under polarized light gave negative results.Nodular aggregations of mononuclear histiocytes with giant cells in the hypodermis (hematoxylin and eosin, ×100)imageChest X‐rays revealed a moderate bilateral hilar gland enlargement, but the radioactive gallium‐67 uptake was normal. Pulmonary function tests were also normal, except for the single‐breath carbon monoxide test (4.54 mmol/min/kPa: 68% of predicted). Serum angiotensin‐converting enzyme (ACE) was raised to 77 U/I (normal; 8–52). The intradermal response to purified protein derivative was found to be suppressed.To confirm the diagnosis of sarcoidosis, the patient underwent a broncho‐alveolar lavage (BAL). The immunophenotyping analysis of T‐lymphocyte subsets in the BAL was suggestive of sarcoidosis, showing a marked increase of CD4 positive cells (71.2%), CD8 positive cells being normal (24.6%).Considering that the only systemic manifestation of sarcoidosis was a moderate bilateral hilar enlargement, the cortisone acetate dosage was kept unchanged, and only a regular follow‐up was recommended.
Lichenoid secondary syphilis
Authors: Carbia Sergio Gabriel , Lagodín César , Abbruzzese Mario , Sevinsky Luis , Casco Ricardo , Casas José , Woscoff Alberto 
Published: March 2003

Argentina Case 1 A married, heterosexual, promiscuous, 29‐year‐old white man had experienced an asymptomatic eruption on the trunk and left palm for the last 3 months. After 2 months, the trunk involvement disappeared, but 2 weeks later lip and tongue lesions developed. No history of genital ulcer was found.The physical examination revealed asymptomatic, violaceous, erythematous, flat‐topped papules in an annular pattern, 5–10 mm in size, on the left palm (Fig. 1). Painful vesicular lesions surrounded by a red halo, with erosions on the labial mucosa and defined areas of depapillation on the posterior aspect of the tongue, were observed. The genitalia and soles were free of lesions. The clinical findings suggested lichen planus or secondary syphilis.Flat‐topped papules on the palmimageA biopsy specimen of the palm was consistent with a lichenoid dermatitis, with hyperkeratosis, parakeratosis, acanthosis, striking elongation of the rete ridges, leukocytic exocytosis, and sparse colloid bodies. A band‐like dense lymphomonocytic infiltrate without plasma cells was present throughout the papillary dermis. The infiltrate obscured the dermo‐epidermal interface (Fig. 2). A lip biopsy showed a subacute inflammatory dermatitis. Venereal Disease Research Laboratory (VDRL) titers were high (1/1024) and fluorescent treponemal antibody absorbed (FTA‐ABS) test was positive. Enzyme‐linked immunosorbent assay (ELISA) for human immunodeficiency virus (HIV) was negative. After two weekly doses of benzathine penicillin G (2.4 million units), all lesions cleared within 3 weeks.Parakeratosis and acanthosis with thinning of the rete ridges. Lichenoid infiltrates of lymphocytes and monocytes (hematoxylin and eosin; original magnification ×40)image Case 2 A 42‐year‐old white man had developed cutaneous lesions involving the trunk and extremities over the past 2 weeks. Anorexia, malaise, and generalized arthralgia were also noted. He was married and denied casual sexual partners. Itching, erythematous, flat‐topped papules with scaling and some crusts on the trunk and extremities were observed (Fig. 3). The palms and soles were free of lesions. The glans penis showed painless, erythematous, shallow erosions. Neck microlymphadenopathy was present. All other physical findings were normal.Lichenoid eruption on the trunkimageFTA‐ABS and VDRL (1/1024) tests were reactive. ELISA for HIV was negative. The dark field microscopy examination of the glans penis exudate revealed Treponema pallidum with no spiraling motion. A biopsy specimen of the trunk showed a lichenoid dermatitis with increased numbers of perivascular and periadnexial plasma cells, in the superficial and deep dermis (Fig. 4). Two weekly doses of benzathine penicillin GSuperficial perivascular dermatitis; dermo‐epidermal interface lichenoid (hematoxylin and eosin; original magnification ×100)image(2.4 million units) were given. All lesions faded in 3 weeks.
Head lice in pupils of a primary school in Australia and implications for control
Authors: Speare Richard , Buettner Petra G. 
Published: March 2003

Abstract Background Anecdotal reports suggest that head lice infestations are a common problem in school‐aged children in Australia; however, only a few data are available. The present study aimed to determine the prevalence of infestation with head lice in children in an urban Australian school. Methods All 735 pupils from grades preschool to five of a government run primary school were invited to participate in the cross‐sectional survey. Overall, 212 boys (46.5%) and 244 girls from 29 classes were examined. The main outcome measures were:1the detection of lice or eggs by visual examination of the child’s head, and classification into “not infested” and “infested;” infested cases were further classified into “active infestation” (lice or viable eggs found) or “inactive infestation” (only unhatched eggs found);2for each child, a parent or guardian was asked to complete a standardized questionnaire. Results Of the 456 children examined, 33.7% (95% confidence interval = 95%‐CI =[26.9%, 40.4%]) had evidence of infestation with head lice, 21.0% (95%‐CI = [15.2%, 26.8%]) with active infestation. The prevalence of infestation (active plus inactive) varied greatly between classes, ranging from zero to 72.2% (p < 0.001). Head lice were more prevalent in girls than boys (p < 0.001). Analysis of questionnaires showed that 47.7% (95%‐CI = [43.0%, 52.4%]) of the children had been infested with head lice in the previous 6 months. For children with active pediculosis capitis on examination, 14.0% (95%‐CI = [7.9%, 22.4%]) of parents or guardians had not noticed the infestation. Conclusions In an urban primary school in Australia, head lice infestation was present at a hyperendemic level. Clustering by class indicated the classroom as a main source of infestation. Control strategies implemented in schools and including the education of teachers and parents need to be evaluated.
Deep fungal and higher bacterial skin infections in Thailand: clinical manifestations and treatment regimens
Authors: Mahaisavariya Punkae , Chaiprasert Angkana , Apichati Sivayathorn, DR.reR.naT., , Khemngern, Supakan 
Published: March 2003

Abstract Background Deep fungal and higher bacterial skin infections occur fairly frequently in Thailand. Methods Cases with a provisional diagnosis of deep fungal and higher bacterial infections were prospectively collected from 1994 to 1997 in the Granuloma Clinic, Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. Demographic data, clinical manifestations, causative organisms, histologic features, treatment, and outcome were investigated. Results The total cases in a 4‐year period numbered 27. The male to female ratio was approximately 1 : 1. Mycetoma was most common, followed by chromoblastomycosis. Actinomycetoma was similar in incidence to eumycetoma. The only causative organism that could be identified among the mycetoma cases was Cladosporium carrionii, which caused mycetoma of the buttock of an aplastic anemia patient at the site of bone marrow aspiration. Surgical treatment was recommended for eumycetoma. Chromoblastomycosis was caused by C. carrionii and F. compactum and responded well with itraconazole orally. Mycotic abscesses were found in four cases, basidiobolomycosis in two cases, and cutaneous nocardiosis in one case. Cotrimoxazole was recommended in the treatment of actinomycetoma, cutaneous nocardiosis, and basidiobolomycosis. Conclusions Localized, chronic, slow, progressive, and usually asymptomatic were the main cutaneous manifestations of deep fungal and higher bacterial skin infections. A skin biopsy for histologic study and culture identification should be performed in every suspected case. The causative organisms were found in the histologic sections of every case, but only about one‐third were found by culture.
A survey of reference accuracy in two Asian dermatologic journals (the Journal of Dermatology and the Korean Journal of Dermatology)
Authors: Lee Sung Yul , Lee Jong Suk 
Published: March 2003

Abstract Background The reference list is an important part of a scientific article. To be useful, it must be accurate. Methods To evaluate the reference accuracy in the Journal of Dermatology and the Korean Journal of Dermatology, we randomly selected 100 references from each journal and checked them against the original articles. Results The overall rate of citation errors was 24% in the Journal of Dermatology and 33% in the Korean Journal of Dermatology. Errors in the title and author names were common, each occurring in about half of the citation errors. The overall rate of quotation errors was 14% in the Journal of Dermatology and 27% in the Korean Journal of Dermatology. Conclusions This study shows that the rate of citation errors is unacceptably high in the Journal of Dermatology and the Korean Journal of Dermatology, which significantly diminishes the value of the reference list. We would strongly urge that the peer review of citation and quotation accuracy should be strengthened.
Density of viral particles in pre and post Nd:YAG laser hyperthermia therapy and cryotherapy in plantar warts
Authors: El‐Tonsy Mohamed Hany , Anbar Tag El‐Din , El‐Domyati Moetaz , Barakat Manal 
Published: March 2003

Abstract Background Warts often present a difficult treatment problem for clinicians because of the lack of specific antipapillomavirus agents. Plantar warts, in particular, represent a therapeutic challenge. Methods Twenty‐five patients with plantar warts were treated with Nd:YAG hyperthermia and another 25 were treated with cryotherapy. Biopsies were taken before and after treatment in both groups and were examined for the presence of human papillomavirus deoxyribonucleic acid (HPV DNA) using in situ hybridization (ISH). Results HPV DNA was detected in 100% of untreated warts and in 96% of cryotreated warts, but was not detected in any of the hyperthermia‐treated warts. Conclusions HPV is more vulnerable to hyperthermia than to cryotherapy.
A controlled trial of traditional Chinese herbal medicine in Chinese patients with recalcitrant atopic dermatitis
Authors: Fung Adrian Y. P. , Look Paul C. N. , Mrcpi . , Fhkam . , Chong Lai‐Yin , Fhkam . , But Paul P. H. , Wong Eric , Ma . 
Published: March 2003

Abstract Background There have been published reports from the United Kingdom of good responses to the use of traditional Chinese herbal medicine (Zemaphyte®, Phytopharm Plc, Cambridge, UK) in treating recalcitrant atopic dermatitis. We conducted a double‐blind, placebo‐controlled, cross‐over study among Chinese patients with recalcitrant atopic dermatitis using this same herbal preparation. Methods Forty patients were recruited. They were given Zemaphyte® and placebo in random order, each for 8 consecutive weeks with a 4‐week wash‐out period in between. Scores based on the severity and extent of four clinical parameters (erythema, surface damage, lichenification and scaling) were recorded at baseline and at 4‐weekly intervals throughout the 20‐week trial period. Results Thirty‐seven patients completed the trial. There was a general trend of clinical improvement with time throughout the trial period in both patient groups, irrespective of whether they received Zemaphyte® or placebo first. Zemaphyte®, however, offered no statistically significant treatment effect over placebo for all four clinical parameters, except for lichenification at week 4. There were no significant carry‐over effects. Blood tests for hematologic, renal and liver functions were all normal throughout the trial. Conclusions Zemaphyte® did not seem to benefit Chinese patients with recalcitrant atopic dermatitis in our study. Further research is required to evaluate its efficacy.
Henoch–Schönlein purpura induced by clarithromycin
Authors: Goldberg Elizabeth I. , Shoji Toru , Sapadin Allen N. 
Published: March 2003

An 84‐year‐old Indian woman with no significant past medical history and no known drug allergies had been prescribed clarithromycin (250 mg twice daily) for pneumonia. The patient was receiving no other medications. Ten days after starting treatment, the patient developed a mild fever, eruption, and swelling of the ankles. Several days later, the patient developed a spreading, nonpainful, nonpruritic eruption, joint pain, gastrointestinal bleeding, and general malaise. Skin examination revealed numerous palpable purpuric macules and papules and petechiae on the lower extremities, mostly below the knees, and on the right hand. There were large blistering lesions around both ankles, some of which had ulcerated and had a necrotic center (Fig. 1). Blood streaked stool was noted during rectal examination. Laboratory tests showed a normal white blood cell count, hematocrit, and hemoglobin. Serum urea nitrogen was 22 mg/dL (8–18 mg/dL) and creatinine was normal. Urinalysis revealed proteinuria of 0.9 g/24 h (<0.15 g/24 h) and a microscopic hematuria. Antistreptolysin O, antinuclear antibodies, cryoglobulins, and hepatitis serologies were all negative. Histology of the skin showed leukocytoclasticExtensive purpura on the distal legs. Overlying the medial malleolus of the left ankle is a large crusted erosion. An ischemic but intact blister roof is apparent at the peripheryimagevasculitis of superficial vessels with extravasation of red blood cells (Fig. 2). Direct immunofluorescence revealed immunoglobulin A (IgA) in superficial dermal vessels. Treatment with prednisone (1 mg/kg/day) was started and the arthralgias, hematochezia, and eruption resolved over the next 3 days. Renal function remained impaired, however, and the patient was discharged with a proteinuria of 0.56 g/24 h (<0.15 g/day) on prednisone and omeprazole.Medium power picture showing fibrinoid necrosis of superficial vessels, neutrophilic infiltrate, and karyorrhectic debris (hematoxylin and eosin, ×100)image
Cutaneous leishmaniasis in Yemen
Authors: Khatri Mishri Lal , Haider Nasser 
Published: March 2003

AbstractBackground Cutaneous leishmaniasis is widespread in the Yemen, but has not been fully documented.Methods We have studied 42 cases from the Hajjah and Amran Governorates of the Yemen Republic. The clinical profile of these cases was recorded in a special protocol. The diagnosis was based on positive slit skin smear and histopathologic studies when needed.Results The age of the patients ranged between 1 and 65 years (median age, 19 years) and the duration of the disease ranged between 2 months and 12 years (median duration, 6 months). Most of the patients had a single lesion. Slit skin smear was positive for parasites in 35 cases (highly positive in 15). From the analysis of features, the disease could be classified into dry type (31 patients), wet type (seven patients), and chronic cutaneous leishmaniasis (four patients). Most of the patients required prolonged (4–6 weeks) treatment with sodium stibogluconate; the smear was still positive in eight patients, seven of whom were further treated successfully with a combination of rifampicin and isoniazid for 2–3 months. One who was treated successfully with intralesional injections of sodium stibogluconate.Conclusions Cutaneous leishmaniasis in this region seems to be endemic, has a long chronic course, shows a highly positive smear even 1–6 years after onset, and gives an inadequate response to prolonged systemic therapy. Further epidemiologic studies and taxonomic differentiation of the species are required.
Congenital self‐healing histiocytosis (Hashimoto–Pritzker)
Authors: Larralde Margarita , Rositto Alicia , Giardelli Margarita , Gatti Carlos F. , Muñoz Andrea Santos 
Published: March 2003

Abstract Background Congenital self‐healing Langerhans cell histiocytosis (CSHLCH) is a rare condition, initially seen at birth or in the neonatal period, with generalized papules, vesicles, or nodules. Affected infants are otherwise well and the skin lesions tend to involute spontaneously within weeks to months. Methods Twelve patients with CSHLCH were seen from 1989 to 1998. Results Eight patients were girls and four were boys and all presented with lesions at birth which disappeared 1–3 months later. The lesions consisted of numerous brownish‐red papules, papulovesicles, crusts, and nodules distributed on the face, limbs, palms, and soles. Two patients had oral mucosal lesions, and one had ulcerated lesions that evolved leaving hypochromic macules. Light microscopy showed a histiocytic infiltrate in the papillary dermis with epidermotrophism. Two cases were studied by electron microscopy: the Langerhans cells showed Birbeck granules and laminated corpus in their cytoplasm. Immunomarking with S100 protein was performed in all 12 patients and was positive. CD1 was also tested in four cases and was positive. Conclusions Because CSHLCH is a rare condition, we emphasize that, although it is usually a benign, self‐limited entity, careful evaluation for systemic disease must be performed and long‐term follow‐up must be carried out to detect evidence of relapse or progression of the disease; this is essential when treating these patients.
Chromoblastomycosis in India
Authors: Sharma Nand Lal , Sharma Ramesh Chander , Grover Prem Singh , Gupta Manohar Lal , Sharma Ashok Kumar , Mahajan Vikram Kumar 
Published: March 2003

Abstract Background Four patients with chromoblastomycosis are presented. An additional 30 infected Indian patients are reviewed. Results These 34 patients ranged in age from 12 to 80 years with a male to female ratio of 5.8 : 1. Onset before the age of 20 years was seen in 24% of cases which was comparatively high. Culture was positive in 72% of cases and sclerotic bodies were observed in 84% of cases. A relatively higher prevalence (15%) of Fonsecaea compacta was observed. Unusual cutaneous sites afflicted were the penile shaft, vulva, and ala of the nose, and unusual extracutaneous spread was seen in the pleural cavity, ileocecal region, laryngotracheal area, and tonsils. Extracutaneous involvement was seen in 24% of cases. Overlapping infection with another fungus, Geotrichum candidum, was seen in one case. Conclusions Combination therapy with two azoles was attempted with some success for clinical cure.