bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vivo delayed‐type hypersensitivity in 109 patients with vitiligo
Authors: Behrens‐Williams Stefanie C. , Peters Eva M. , Schallreuter Karin U. 
Published: March 2003

AbstractBackground  Although the etiology of the depigmentation disorder vitiligo is still not completely understood, many investigators believe that an autoimmune reaction may play a major role. In this regard, T‐lymphocyte‐mediated immunity has been implicated frequently in the pathogenesis of the disease. Most studies have applied in vitro testing of cell‐mediated immunity, however, rather than in vivo measurements. Therefore, our study was undertaken to define the cutaneous delayed‐type hypersensitivity (DTH) in vivo reaction in association with the absence/presence of serum thyroid autoantibodies, which are a good representative marker for autoimmunity in patients with vitiligo.Methods  DTH was evaluated in the normal pigmented skin of 109 vitiligo patients (29 men and 80 women) and in the depigmented skin of 27 of this group (5 men and 22 women) using the dermal application of seven common recall antigens together with a negative control. Individuals were considered to be hypoergic if the DTH sum score was ≤ 5 mm in women or ≤ 10 mm in men, or if they responded to only one or two antigens.Results  The mean sum score was 10.2 ± 8.4 with an average of 2.3 ± 1.6 positive reactions in depigmented skin vs. a sum score of 12.4 ± 9.0 with an average number of 2.6 ± 1.6 positive reactions in normal pigmented skin. There was no statistically significant difference between depigmented and normal pigmented skin using the paired t‐test (P > 0.05). Further evaluation of these data showed no significant correlation between the presence of thyroid autoantibodies as well as selected clinical parameters and an aberration in cutaneous DTHConclusions  In contrast to earlier reports, our in vivo studies of cutaneous DTH reactions revealed no clinically significant aberrant cellular immunity in this patient group. These results indicate that the immune reaction in vitiligo may be only a secondary event in the pathogenesis of the disease.
Wolf's isotopic response: Trichophyton rubrum folliculitis appearing on a herpes zoster scar
Authors: Tüzün Yalçın , İşçimen Aydın , Göksügür Nadir , Demirkesen Cuyan , Tüzün Binnur 
Published: March 2003

A 37‐year‐old man was first seen in November 1998 with a unilateral painful eruption of grouped small vesicles at the right side of his thorax. His general health was good. He was diagnosed as having herpes zoster, which was successfully, treated with oral acyclovir 800 mg, five times a day. Five months later, and after complete resolution of the herpes zoster, he developed a pustular eruption on exactly the same area of his first herpetic lesion. There was a diffuse distribution of pustules on the dorsal part of the dermatome, and a grouped pattern on the ventral side ( Fig. 1). A punch biopsy was performed for differential diagnosis of recurrent herpes zoster and folliculitis. Methicillin‐resistant Staphylococcus aureus colonies were isolated from the bacterial culture of the pustular content. Cefadroxil monohydrate 500 mg twice a day and the application of fucidic acid ointment were prescribed. There was no improvement at the end of the second week of therapy.Clinical appearanceimageA histopathologic study demonstrated hyperkeratosis, acanthosis, focal accumulation of neutrophils and bacteria in the epidermis, and a perivascular and perifollicular infiltration of eosinophils, lymphocytes, and histiocytes in the dermis ( Fig. 2). After the diagnosis of eosinophilic pustular dermatosis was histopathologically confirmed, fungal folliculitis and immunosuppressive conditions were investigated. Routine blood tests were within the normal ranges. The human immunodeficiency virus (HIV), hepatitis C virus (HCV), and anti‐hepatitis B surface antibody (anti‐HBs) tests were negative, but the hepatitis B surface antigen (HBsAg) test was positive. Abundant fungal hyphae were seen in potassium hydroxide under direct microscopic examination of the pustule content, and a fungal culture was performed. Although no evidence of fungal infection was demonstrated in repeated periodic acid–Schiff (PAS) staining of punch biopsy specimens, Trichophyton rubrum was isolated from fungal culture. The patient was then given a regimen of itraconazole pulse therapy (400 mg/day, for 7 days a month, repeating the monthly cycle three times) and cycloproxolamine cream. Two months later, at the end of therapy, only a few pustules remained, and these completely disappeared after another 5 months.Eosinophilic pustular folliculitis: dense eosinophilic infiltration within and around the hair follicle (hematoxylin and eosin, × 400)image
Recognition of melanoma cell antigens with antibodies present in sera from patients with vitiligo
Authors: Rocha Irene Machado , Oliveira Lorena Juliana Nascimento , De Castro Lia Cândida Miranda , De Araújo Pereira Ledice Inácia , Chaul Aiçar , Guerra Jaqueline Gomes , Silvestre Marilene Chaves , Batista Karina Maria , Pereira Fabiana Araújo , Gomide Maria Abadia Consuelo , Guillo Lidia Andreu 
Published: March 2003

AbstractBackground  Patients with vitiligo show specific losses of integumentary melanocytes, probably due to autoimmunity against melanocytes. We attempted to determine the presence of antibodies against pigment cell antigens in the sera of vitiligo patients.Methods  Detergent‐solubilized human melanoma cells were submitted to electrophoretic separation and immunoblotted against serum samples obtained from 19 patients with vitiligo and from 20 age‐ and sex‐matched healthy individuals.Results  Eighty‐nine per cent of patients with vitiligo had antibodies to one or more pigment cell antigens. Similar antibodies were detected in 20% of healthy individuals. Antigens of 165, 90, and 68 kDa were recognized by the antibodies present in sera from 11%, 26%, and 37% of vitiligo patients, respectively, and in none of the normal sera. All patients with familial vitiligo also had antibodies to these three proteins.Conclusions  Proteins of 165, 90, and 68 kDa are specifically recognized by antibodies present in the sera of vitiligo patients and in all patients with genetic vitiligo. Whether or not these proteins might be implicated in the destruction of melanocytes by the immune system in vitiligo remains to be evaluated.
Cornifying Darier's disease
Authors: Katta Rajani , Reed Jon , Wolf John E. 
Published: March 2003

A 48‐year‐old Caucasian man recounted the onset of keratotic papules on the trunk at the age of 8 years, with subsequent spread to the forearms, scalp, and forehead. His most severe disease was present on the legs. He complained of pain, itching, and noted exacerbations in the summer and with sweating. The family history was negative.On physical examination, the most striking finding was that of extensive, markedly hyperkeratotic plaques on the lower legs >(Fig. 1). His scalp, forehead, chest, and back exhibited mild involvement, with scattered brown keratotic papules, while his forearms showed mildly hyperkeratotic plaques. Flat‐topped brown papules were present on the dorsum of the hands, with a few keratotic papules on the palms, and a few nails with distal notching and red longitudinal streaks. There were no palmar pits or oral mucosal lesions.Extensive hyperkeratotic plaques on the legsimageA shave biopsy was performed of a plaque on the leg, and showed a papillomatous and markedly hyperkeratotic lesion >(Fig. 2). Suprabasal acantholysis in the elongated rete produced characteristic lacunae. The acantholysis was associated with dyskeratosis including corps ronds and grains >(Fig. 3). Together, these features were characteristic of Darier's disease.Suprabasal acantholysis with characteristic lacunae. Original magnification, × 52imageTypical corps ronds and grains. Original magnification, × 488imageTreatment years earlier with topical retinoids, topical steroids, topical keratolytics, and multiple oral antimicrobials had been unsuccessful, and isotretinoin had been discontinued due to elevated triglycerides. Treatment was initiated with acitretin and, after 3 months, mild improvement was noted
Cutaneous findings encountered in brucellosis and review of the literature
Authors: Metin Ahmet , Akdeniz Hayrettin , Buzgan Turan , Delice Ibrahim 
Published: March 2003

AbstractBackground  Human brucellosis is an infectious disease produced by Brucella species: small, coccoid or rod‐like, aerobic, Gram‐negative bacteria. The infection is common in developing countries, and can also affect the skin. Its prevalence is high in our region of Turkey, where stockbreeding is one of the main economic sources, compared with the industrially developed areas of Turkey, and dermatologic complaints due to brucellosisare fairly common.Materials and methods  One hundred and three patients with serologically and clinically confirmed brucellosis were studied in order to investigate the prevalence of cutaneous findings and their variability in brucellosis. Fifty‐two (50.49%) were males and 51 (49.51%) were females with an age range of 4–70 years (mean, 30.45 ± 15.08 years).Results  Of these patients, 14 (13.59%) had cutaneous findings probably related to brucellosis. These findings were more frequent in females (11 cases) than males, and most of the females (eight cases) were housewives; three were students. Urticaria‐like papules and plaques were the most common findings; they were seen in six (35.3%) patients. One case had livedo reticularis and another palmar erythema, which have not been reported previously. No relationship was observed between the serologic values and the cutaneous findings.Conclusions  Cutaneous findings in our cases were more prevalent than in other reported studies. It is important to emphasize that cutaneous lesions are not specific to brucellosis and may be seen in a variety of other dermatologic diseases caused by many agents; therefore, these agents should be kept in mind in the differential diagnosis.
Histologic features seen in changing nevi after therapy with an 810 nm pulsed diode laser for hair removal in patients with dysplastic nevi
Authors: Soden Cylburn E. , Smith Kathleen , Skelton Henry 
Published: March 2003

AbstractBackground  The majority of lasers used for hair removal target melanin as the chromophore. In contrast with other cutaneous applications of lasers, lasers used for hair removal must generate a limited, controlled degree of thermal damage to permanently remove hairs.Aim  To remove excess back hair from two male patients, one with a history of multiple nevi, and prior biopsies showing features of dysplastic nevi, and the other with large nevi greater than 6 mm in diameter and a family history of malignant melanoma.Methods  Both patients received monthly treatments with an 810 nm, pulsed, high‐power diode laser using a fluence of 20 J/cm2 and 25–30 J/cm2, respectively, and a pulse duration of 30 ms.Results  Both patients presented 1 month after their last treatment with changing nevi within the treatment areas. Neither patient had clinical inflammation or other alterations suggestive of change in the nevi related to treatment. Thus, the nevi were excised with no mention of the previous laser treatment. The histologic features in all nevi were similar. There was subepidermal blister formation with elongation and disruption of nevus cells. There was homogenization of the collagen within the papillary dermis in all lesions. Only small foci of nevus cells could be identified in the dermis in some of the biopsy specimens. In these biopsy specimens, the dermal stromal matrix homogenization extended into the reticular dermis.Conclusions  Laser targeting of nevus cells and surrounding structures may produce clinically atypical nevi in areas previously treated for hair removal. This should be kept in mind, especially in patients with a history of dysplastic nevi or with a personal or family history of malignant melanoma.
Transient CD30+ nodal transformation of cutaneous T‐cell lymphoma associated with cyclosporine treatment
Authors: Pielop Josie A. , Jones Dan , Duvic Madeleine 
Published: March 2003

AbstractBackground  Mycosis fungoides (MF) may evolve from pre‐existing chronic atopic or psoriasiform dermatitis and the histology can be equivocal. Early patch and plaque lesions of MF may evolve into tumors, disseminate to lymph nodes, bone marrow, and internal organs, and/or undergo transformation to a large cell size.Methods  A patient with a history of ‘‘atopic dermatitis’' followed by ‘‘psoriasis’' rapidly developed exfoliative erythroderma and axillary lymphadenopathy following treatment with cyclosporine. At presentation, biopsy specimens of skin lesions and lymph nodes and staging were obtained. We present the treatment and follow‐up of this patient and review the medical literature for similar cases.Results  Multiple skin biopsy specimens from lesions revealed changes consistent with low‐grade, cutaneous, T‐cell lymphoma (MF) without evidence of large cell transformation and psoriasiform epidermal hyperplasia. CD30+ large cell transformation was present in the lymph node. Adenopathy and erythroderma resolved without systemic therapy following discontinuation of cyclosporine and treatment with psoralen/ultraviolet A (PUVA), isotretinoin, interferon‐α, and antimicrobials.Conclusions  This case documents a close relationship between atopy, psoriasis, and the development of cutaneous T‐cell lymphoma, and illustrates that an immunosuppressive agent, cyclosporine, can dramatically alter the course of the disease.
Topical 3.0% diclofenac in 2.5% hyaluronan gel in the treatment of actinic keratoses
Authors: Wolf John E. , Taylor Joseph Richard , Tschen Eduardo , Kang Sewan 
Published: March 2003

AbstractBackground  Actinic keratoses (AKs) are epidermal skin lesions with the potential to develop into invasive squamous cell carcinoma (SCC). Treatment at an early stage may prevent development of SCC. Current treatment options are highly destructive and associated with significant side‐effects. Early studies with topical diclofenac were encouraging and led to its evaluation for the treatment of actininic keratosis. Previous studies have demonstrated that 3% diclofenac in 2.5% hyaluronan gel is effective and well tolerated in the treatment of AK. The present study was designed to further explore the therapeutic potential of this gel.Methods  This randomized, double‐blind, placebo‐controlled trial involved outpatients with a diagnosis of five or more AK lesions contained in one to three 5 cm2 blocks. Patients received either active treatment (3% diclofenac gel in 2.5% hyaluronan gel) or inactive gel vehicle (hyaluronan) as placebo (0.5 g b.i.d. in each 5 cm2 treatment area for 90 days). Assessments included the Target Lesion Number Score (TLNS), Cumulative Lesion Number Score (CLNS), and Global Improvement Indices rated separately by both the investigator (IGII) and patient (PGII).Results  Results obtained from 96 patients at follow up (30 days after end of treatment) indicated that a significantly higher proportion of patients who received active treatment had a TLNS = 0 compared to the placebo group (50% vs. 20%; P < 0.001). There was also a significant difference between the two groups in CLNS, with 47% of patients in the active treatment group having a CLNS = 0 compared with only 19% in the placebo group (P < 0.001). The proportion of patients with an IGII score of 4 (completely improved) at follow‐up was 47% in the active treatment group compared with only 19% in the placebo group (P < 0.001); for PGII these values were 41% vs. 17%, P < 0.001. Both treatments were well tolerated, with most adverse events related to the skin.Conclusions  Topical 3% diclofenac in 2.5% hyaluronan gel was effective and well tolerated for the treatment of AK.
Oral erosive lichen planus associated with thymoma
Authors: Calista Donato 
Published: March 2003

A 43‐year‐old man was initially seen in a state of deep prostration. He reported a 1‐month history of fever (39.2 °C), fatigue and painful oral erosions that made eating impossible. His past medical history was unremarkable. The patient denied having taken any drug in the previous 6 months. Physical examination revealed multiple erosions on the lateral aspects of his tongue and the inner surface of the cheeks (Fig. 1). There was also some pruritic, scattered, reddish‐blue papules on the flexor side of his forearms. Laboratory data, serum immunoglobulin levels, ANA, and lymphocyte subset studies were normal; serologic markers for hepatitis B and C virus were negative. Two biopsy specimens where taken from a lesion on the wrist and the border of the lower lip, respectively. They showed vacuolar degeneration and colloid bodies in the epithelium and a dense subepithelial lymphocytic infiltrate, both consistent with the diagnosis of lichen planus (LP) (Fig. 2). Direct immunofluorescent staining was negative. A diagnosis of LP was made and the patient started oral therapy with prednisone 1 mg/kg once daily. After 15 days clinical improvement was evident and the dose of prednisone was reduced. Two months after our first observation, the patient's condition had improved further, but a nonproductive cough appeared. Chest radiography showed a mediastinal mass (Fig. 3) which was excised via median sternotomy. Microscopic examination showed a well‐encapsulated mixed type AB thymoma. A CT scan of the chest and abdomen did not reveal metastasis. In the following months, cutaneous LP regressed while oral erosive lichen planus (OELP) persisted but was well controlled by a low dosage steroid regimen. At a 12‐month follow‐up the patient's condition was still good.Erosions of the tongue covered by whitish fibrinous materialimageBiopsy from the lower lip showing vacuolar degeneration of the epidermal basal layer and a dense band‐like lympho‐istiocytic infiltrate in the upper dermisimageCT image showing the mediastinal massimage
Treatment of arsenical keratosis and Bowen’s disease with acitretin
Authors: Yerebakan Özlem , Ermis Oya , Yilmaz Ertan , Basaran Erdal 
Published: March 2003

AbstractBackground Long‐term exposure to arsenic is associated with the development of arsenical keratosis, Bowen’s disease, squamous cell carcinoma, and basal cell carcinoma. The efficacy of acitretin therapy was examined in two patients with cutaneous arsenical neoplasms.Methods Lipid profile, hematological and liver function tests were performed regularly during the therapy at monthly intervals.Results After the third month of treatment, improvement of lesions of arsenical keratosis and Bowen’s disease were observed in both patients. For the first patient who received 1 mg/kg daily acitretin for 10 months nearly total clearing was obtained at the end of therapy. The second patient discontinued the treatment after a period of 5 months because of symptomatic side‐effects. During therapy no new lesions and no laboratory side‐effects were observed in either patient.Conclusions Although these results need to be confirmed by larger, long‐term trials, it appears that acitretin is effective in the treatment of Bowen’s disease related with arsenic, as well as arsenical keratosis.
Reactive angioendotheliomatosis and sarcoidosis
Authors: Shyong Eileen Q. , Gorevic Peter , Lebwohl Mark , Phelps Robert G. 
Published: March 2003

AbstractAngioendotheliomatosis is an uncommon condition that manifests with both cutaneous and systemic clinical signs and symptoms. It is characterized histologically by the proliferation of endothelial cells within vascular lumina resulting in the obliteration of the involved vessels secondary to intravascular thrombi. Cases have been classically divided into the benign or reactive variants and a malignant variant. The reactive variant is considerably more rare and has mainly been described in patients with systemic infections including subacute bacterial endocarditis. In this report we present a case of reactive angioendotheliomatosis in a patient with sarcoidosis.
Haplotype associations of the major histocompatibility complex with psoriasis in Northeastern Thais
Authors: Choonhakarn Charoen , Romphruk Amornrat , Puapairoj Chintana , Jirarattanapochai Kunya , Romphruk Arunrat , Leelayuwat Chanvit 
Published: March 2003

AbstractBackground  To evaluate the distributions of the human leukocyte antigen (HLA) at class I and II loci that may contribute to the genetic susceptibility to psoriasis patients in the north‐eastern Thai population.Materials and methods  We analyzed the allelic frequencies of HLA class I and II by using the polymerase chain reaction‐amplification refractory mutation system (PCR‐ARMS) technique and polymerase chain reaction‐single stranded conformation polymorphism (PCR‐SSCP), respectively, in 140 north‐eastern Thais with psoriasis that were sudivided into two groups: one with age at onset < 40 years (type I psoriasis; 95 cases) and the other with age at onset > 40 years (type II psoriasis; 45 cases). Three hundred healthy unrelated north‐eastern Thais were used as controls.Results  HLA‐A*01, ‐A*0207, ‐A*30, ‐B*08, ‐B*13, ‐B*4601, ‐B*57, ‐Cw*01, ‐Cw*0602, and ‐DRB1*07 were positively associated with type I psoriasis, whereas HLA‐A*24, ‐A*33, and ‐Cw*04 were negatively associated with type I psoriasis with statistical significance when compared to the controls. The Cw*0602 allele showed the strongest correlation with this type. In addition, the frequencies of HLA‐A*0207, ‐A*30, ‐Cw*01, and ‐DRB1*1401 were significantly increased in type II psoriasis. HLA‐A*207, ‐B*4601, ‐Cw*01, ‐DRB1*09, ‐DQB1*0303 (AH46.1), HLA‐A*01‐B*57‐Cw*0602‐DRB1*07‐DQB1*0303 (AH57.1), and HLA‐A*30, ‐B*13, ‐Cw*0602, ‐DRB1*07, and ‐DQB1*02 (AH13.1) were identified as high‐risk major histocompatibility complex (MHC) halotypes for psoriasis patients in the early onset group in north‐eastern Thais.Conclusions  This study demonstrates not only the differential association between HLA markers and types of psoriasis according to age at onset, but also a newly found high‐risk and a protective haplotype in Thai psoriasis patients.
Evaluating the efficacy of allopurinol and meglumine antimoniate (Glucantime) in the treatment of cutaneous leishmaniasis
Authors: Esfandiarpour Iraj , Alavi Afsáneh 
Published: March 2003

AbstractBackground Cutaneous leishmaniasis is a common disease in Iran, particularly in Kerman province. It usually occurs via the bite of an infected sandfly.Methods One hundred and fifty patients suffering from cutaneous leishmaniasis were included in this study in Kerman. The patients were randomly divided into three groups. They were matched with regard to age, sex, duration of the disease, and type, number, and site of the lesions. For each group, one of the following therapeutic methods was applied: (i) oral allopurinol (15 mg/kg/day) for 3 weeks; (ii) intramuscular injection of Glucantime (30 mg/kg/day), corresponding to 8 mg/kg/day of pentavalent antimony, for 2 weeks; (iii) combined therapy. The lesions were re‐examined at the end of treatment and 2 and 4 weeks later. The response to treatment was graded as excellent (reduction in the size of the lesion by at least 80% or complete clearance), good (reduction in the size of the lesion by 50%), and poor (minimal or no change in the lesion).Results The overall results indicated that 18% of patients showed excellent response, 6% good response, and 76% poor response in the first group. In the second group, 24% of patients showed excellent response, 6% good response, and 70% poor response. In the third group, 46% of patients showed excellent response, 8% good response, and 46% poor response.Conclusions The results obtained by the three therapeutic methods indicated that combined therapy with allopurinol plus Glucantime was much more effective than that obtained by each of the two drugs when used alone (P < 0.05).