bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tinea manus treated with 1‐week itraconazole vs. terbinafine
Authors: Gupta Aditya K. , De Doncker Piet , Degreef Hugo 
Published: March 2003

A double‐blind, prospective, comparative, randomized study was conducted to determine the efficacy and safety of itraconazole (pulse) given for 1 week against a 2‐week course of terbinafine (continuous) for the treatment of tinea manus. The inclusion criteria were that the clinical diagnosis of tinea manus had to be confirmed by positive mycologic examination (KOH). Individuals had to be 18 years or older and in good general health. Patients with a sensitivity to imidazole or the allylamine derivative were excluded, as were subjects participating in any other investigational drug study within 4 weeks prior to the start of the trial. Other exclusion criteria included women who were pregnant, lactating, or in whom there was a lack of adequate contraception. Patients with a history of chronic liver disease were also excluded, as were individuals with a tinea infection at another anatomic site. Patients receiving any agents known to have an interaction with either itraconazole or terbinafine, including rifampin, phenytoin, digoxin, warfarin, astemizole, terfenadine, cisapride, simvastatin, and lovastatin, were excluded from the study. The patients must not have received systemic antifungal or corticosteroid therapy for at least 30 days, or applied topical antifungals or corticosteroids for at least 14 days, prior to the onset of the study. Patients were withdrawn from the study if a serious adverse event occurred which, in the opinion of the investigator or participant, merited discontinuation from the trial, if the randomization code was broken, or if the subject withdrew consent.Patients were evaluated at baseline, week 1, week 2 (end of double‐blind treatment phase), and week 6 from the start of treatment. The primary efficacy measure was the mycologic cure rate (negative light microscopic examination and culture, or one test negative and the other not positive). The secondary assessment included the clinical global evaluation: healed (absence of signs and symptoms), markedly improved (≥ 50% clinical improvement), considerable residual lesions (< 50% clinical improvement), no change, or worsening. The three symptoms that were evaluated were desquamation, erythema, and pruritus. The severity of the symptoms was graded as: absent, 0; mild, 1; moderate, 2; severe, 3. Clinical success was defined as occurring when patients were healed or markedly improved. Any adverse event that occurred was recorded. The study was approved by an ethical committee and informed consent was obtained from each patient.
Marginal acrokeratoderma and psoriasis: is there an association?
Authors: Rai Ranju , Saraswat Abir , Kaur Inderjeet , Kumar Bhushan 
Published: March 2003

Case 1 A 70‐year‐old housewife presented to us with multiple, asymptomatic, depressed, crateriform plaque lesions over the radial margin of the index finger and thumb and thenar and hypothenar eminences of both hands of 25 years' duration (Fig. 1). There was no history of prolonged sun exposure or repeated trauma to the hands and there were no such lesions on the soles. None of her other family members were affected. We made a provisional diagnosis of keratoelastoidosis marginalis. Skin biopsy revealed an unremarkable epidermis, with minimal lymphocytic infiltration in the upper dermis and hyalinization in the reticular dermis, extending to the deeper dermis. Two years later she returned with well‐defined, erythematous, scaly, mildly itchy plaque lesions over the instep of both feet and the center of both palms. A clinical diagnosis of palmoplantar psoriasis was made.Case 1. Crateriform plaque lesions on the hands. Note the palmoplantar psoriasisimageA careful search to discover any correlation between these two disorders revealed that plaque lesions with a central saucer‐like depression on the sides of the fingers and the palmar surface have been noted in patients with otherwise typical lesions of psoriasis (Caro MR, Senear FE. Psoriasis of the hands. Nonpustular type. AMA. Arch Dermatol Syphilol 1956; 74: 629‐633). We then began to look for these lesions in all patients attending our dermatology clinic. Screening of more than 500 patients suffering from cutaneous disorders other than psoriasis revealed no marginal keratodermas. A careful search of 500 consecutive patients attending our psoriasis clinic revealed two more cases. Case 2 A 23‐year‐old laboratory technician with psoriasis over the center of the palms of 6 months' duration was found to have multiple depressed plaques of 3 × 3 mm along the outer margin of the index finger and inner margin of the thumb on examination (Fig. 2). These had been present before the appearance of classical psoriasis lesions, but the exact duration was not known.Case 2. Depressed plaques along the outer margin of the index fingerimage Case 3 A 62‐year‐old shopkeeper with generalized psoriasis of 2 years' duration was found to have pin‐head to pea‐sized asymptomatic depressed lesions over the margins of the index finger and thumb (Fig. 3). He was worried about them mainly due to their cosmetic appearance. None of the above patients had any gross evidence of actinic damage. All the lesions were crateriform, with no elevated or translucent lesions seen.Case 3. Depressed lesions on the index finger. Note the lesions of psoriasis over the dorsa of the handsimage
Morphology of glass fibers in electronics workers with fiberglass dermatitis – a scanning electron microscopy study
Authors: Hsieh Meng Ying , Guo Yueliang Leon , Shiao Judith Shu Chu , Sheu Hamm Ming 
Published: March 2003

AbstractBackground  Fiberglass is used as a reinforcement filler material in printed circuit boards (PCBs) which are widely used in the electronics industry. In a recent survey, we demonstrated that fiberglass dermatitis is the most common occupational dermatosis among electronics industry workers in Taiwan. Little is known, however, about the morphologic structures of the glass fibers which induce dermatitis. The purpose of this study was to assess the morphology of fiber spicules and to determine the relationship of this structure to fiberglass dermatitis.Methods  Fourteen female patients with a diagnosis of fiberglass dermatitis were selected for study. The diagnosis was confirmed in all patients by positive skin stripping for glass fibers and matching with glass fibers from dust collected in work areas and from samples collected by scraping the edge of PCBs. Samples of collected glass fibers were analyzed by scanning electron microscopy (SEM).Results  SEM of the fiberglass samples revealed that fibers were approximately 10 μm in diameter. In samples from both the edge of PCBs and from dust collected in work areas, SEM revealed that most of the fibers were in bundles of various sizes and lengths. All fibers collected from patients' skin by tape stripping showed a singular spicule, most had a sharp free end, and the lengths were in the range 50–150 μm.Conclusions  Singular glass fibers with a sharp free end and a length of 50–150 μm are most likely to induce fiberglass dermatitis.
Intralesional cryosurgery using lumbar puncture and/or hypodermic needles for large, bulky, recalcitrant keloids
Authors: Gupta Somesh , Kumar Bhushan 
Published: March 2003

AbstractBackground  Keloids are notoriously difficult to treat. A variety of treatment modalities are currently in use, indicating that none is totally satisfactory. Surface cryosurgery is effective for smaller keloids, but not for larger ones. It often results in widespread depigmentation over the surface of the keloids, which may not be desirable, especially in patients with dark skin.Objectives  To determine the efficacy of intralesional (IL) cryosurgery in large, bulky keloids unresponsive to IL steroids, and to observe the extent of depigmentation and other complications produced by the technique.Methods  Twelve patients with large, bulky, symptomatic keloids unresponsive to at least five injections of IL triamcinolone acetonide were included in the study. The age of the patients and the duration of the keloids were in the range 19–50 years and 1–12 years, respectively. The IL cryosurgery device was assembled using a small liquid nitrogen Dewar cylinder, a rubber and a plastic tube taken from a drip‐set, adhesive tape, and hypodermic and lumbar puncture needles. The lumbar puncture or injection needle was introduced through the lesion until it appeared at the other side. Liquid nitrogen was then passed through the needle. The freezing time was between 20 and 30 s. The procedure was repeated for a second freeze–thaw cycle in the same session.Results  The patients underwent a minimum of five up to a maximum of 10 sessions of IL cryosurgery. Seven out of 12 patients showed > 75% flattening. Depigmentation was observed along the tracks of the needles in all the patients, which improved during follow‐up due to pigment spread from the normally pigmented areas in between. At the end of follow‐up, 1–25% of the area remained hypo‐ or depigmented in four patients, 26–50% in six patients, and 51–75% in the remaining two patients.Conclusions  IL cryosurgery should be the preferred mode of therapy for large, bulky keloids, which are unresponsive to IL steroids.
Risk factors for cutaneous melanoma: a case–control study in Argentina
Authors: Loria Dora , Matos Elena 
Published: March 2003

Abstract Background  Although cutaneous malignant melanoma (CMM) is still a relatively rare neoplasm, incidence rates are increasing in many white populations worldwide. A case–control study was performed in Argentina to estimate the risk factors for CMM.Methods  The study group comprised 101 hospital cases with histologically verified melanoma and 246 controls, frequency matched by age, sex, and hospital. Individuals were interviewed about demographic and constitutional factors and sun exposure history.Results  The following risk factors were significant in the logistic analysis: nevi on arms (odds ratio (OR) = 6.3 for 20 or more), skin phototype (OR = 4.1 for type l or ll), holidays spent at the beach (OR = 4 for more than 6 weeks lifelong), fair skin tone (OR = 3.4), light eye color (OR = 2.8), sunburn before the age of 15 years (OR = 2.4), and participation in outdoor sports (OR = 3.2 for more than 5790 h accumulated in a lifetime). Occupational sun exposure was not related to CMM risk. Educational level, hair color, and the presence of freckles were not independent risk factors for CMM.Conclusions  The risk factors found for the studied population, with nearly 90% of the individuals born in Argentina and with nearly 50% with four southern European grandparents, were consistent with those described for other countries. This investigation has resulted in findings that may be of use in preparing actions to prevent CMM in Argentina; these should be directed at those individuals who present the abovementioned risk factors. These actions should include instructions to avoid excessive sun exposure, with the aim to reduce melanoma incidence.
Atopic dermatitis: immunophenotyping of inflammatory cells in skin lesions
Authors: Lugović Liborija , Lipozenočić Jasna , Jakić‐Razumović Jasminka 
Published: March 2003

AbstractBackground  The ever increasing incidence of atopic dermatitis (AD) has stimulated many researchers to use various diagnostic procedures to obtain new data to help elucidate the pathogenesis of the disease.Aims  To perform cell immunophenotyping and to analyze the presence of inflammatory cell‐surface markers in the biopsies of skin lesions from 15 AD patients and five healthy subjects.Methods  Immunohistochemical analysis was performed in a group of AD patients and compared with that in a control group of healthy subjects. Avidin–biotin immunoperoxidase staining of paraffin‐embedded, 4 μm skin sections, with semiquantitative counting of cells labeled with anti‐CD3, anti‐CD8, anti‐CD20, anti‐HLA‐DR (HLA, human leukocyte antigen), and anti‐immunoglobulin E (anti‐IgE) primary antibodies, was used.Results  The results of AD skin analysis showed a greater infiltration of CD3+ lymphocytes, especially of CD4+ subtype, compared with CD8+ lymphocytes. AD skin biopsy specimens also showed a higher intraepidermal HLA‐DR+ Langerhans' cell count, the presence of HLA‐DR on lymphocytes in the dermis, and higher intraepidermal expression of IgE+ cells compared with healthy controls.Conclusions  A statistically significant difference (P < 0.05) was found between the two groups for intradermal and intraepidermal CD3, CD4, and HLA‐DR, intradermal CD8, and intraepidermal IgE+ cells. Immunophenotyping was found to be a useful diagnostic method in AD patients.
Psoriasis vulgaris and acute guttate psoriasis in a family
Authors: Banno Tomohiro , Fujisawa Hiroshi , Satomi Hisae , Imakado Sumihisa , Otsuka Fujio 
Published: March 2003

A 33‐year‐old man (Case 1) developed scaling and erythema on the extensor side of his extremities, head, and back, 3 years before his first visit to our hospital. The lesions spread out to form several plaques and became persistent (Fig. 1a). Serum antistreptolysin O (ASO) was within the normal range and a pharyngeal culture showed normal flora. Histologic findings were compatible with psoriasis vulgaris (Fig. 1b). Topical steroid therapy was effective; however, scaling and erythema persisted.(a) Well‐demarcated scaling and erythema on the leg of Case 1. (b) Skin biopsy specimen from scaling and erythema showing hyperkeratosis, parakeratosis, elongated rete ridges, and inflammatory cell infiltration into the epidermisimageThe 8‐year‐old daughter (Case 2) of Case 1 had suffered severe tonsillitis 2 months prior to the skin eruptions. Numerous rain drop‐like scaly papules appeared on her legs and generalized rapidly (Fig. 2a). Her tonsils were swollen and reddish. Streptococcus pyogenes was detected by pharyngeal smear. The ASO value was at a high level. Histologic examination showed slightly elongated rete ridges, focal lack of the granular layer, parakeratosis, mild spongiosis, and exostosis of neutrophils (Fig. 2b). She was diagnosed with acute guttate psoriasis. Administration of oral antimicrobials reduced the ASO value and led to remission of the disease. After 1 month of antimicrobial treatment, the erythematous papules disappeared.(a) Numerous rain drop‐like scaly papules on the arm of Case 2. (b) Skin biopsy specimen from scaling and erythema showing elongated rete ridges, focal lack of granular layer, parakeratosis, mild spongiosis, and exostosis of neutrophilsimageThe human leukocyte antigen (HLA) typing of the father was HLA‐A24, A31, B7, B39, and Cw7, and that of the daughter was HLA‐A24, A31, B39, and Cw7. Both possessed HLA‐A24, B39, and Cw7. The HLA typing of other family members was also studied. The mother had HLA‐A11, A24, B39, B62, Cw4, and Cw7, and her son had HLA‐A11, A24, B7, B62, Cw4, and Cw7. The result of HLA typing is shown in Table 1.

Human leukocyte antigen (HLA) typing in family members

Father (Case 1)

A24
A31
B7
B39

Mother
A11
A24

B39
B62
Cw4
Cw7

Daughter (Case 2)

A24
A31

B39

Cw7

Son
A11
A24

B7

B62
Cw4
Cw7

Lymphocyte stimulating test was performed using heat‐killed S. pyogenes which were boiled at 70 °C for 10 min and sonicated. The stimulation index was twofold higher in the daughter than in the father (Fig. 3).The result of the lymphocyte stimulating test (LST) using heat‐killed S. pyogenes (S.I., stimulation index)image
Pigmented vulvar macules as a presenting feature of the Carney complex
Authors: Pandolfino Tomi L. , Cotell Stephanie , Katta Rajani 
Published: March 2003

A 27‐year‐old woman was referred by her gynecologist for asymptomatic pigmented vulvar lesions first noted 2 years previously. Medical history was significant for a personal history of atrial myxoma, diagnosed due to a systolic murmur, along with a family (maternal) history of atrial myxoma. The patient also reported irregular menses, increasing and darkening of body and facial hair, and an increase in shoe size.Physical examination revealed multiple 2‐5 mm dark brown to black macules on the labia majora and minora. (Fig. 1) Faint scattered light brown macules were noted on the chest and face. A 2‐mm brown scleral macule was present adjacent to the iris, and scattered small pigmented macules were present on the vermilion border of the lips. A 4‐mm blue‐black papule was found on the upper back, and several firm, 2 mm flesh‐colored papules were found on the abdomen and thigh. Hypertrichosis of both forearms was present, and enlargement of the jaw and hands was noted.Multiple dark brown to black macules on the labia majora and minoraimageHistopathologic evaluation of the blue‐black papule was consistent with a blue nevus, with elongated pigmented spindle cells. Although polygonal cells were noted in the main part of the lesion, these did not meet the criteria for the epithelioid variant of blue nevus, as they were smaller. Histopathologic evaluation of the abdominal lesion (Fig. 2) revealed spindle‐shaped fibroblasts and a mucinous stroma within the upper dermis consistent with a cutaneous myxoma.Hematoxylin‐eosin stain at 112× magnification reveals spindle‐shaped fibroblasts and a mucinous stromaimageEndocrinologic evaluation revealed normal serum levels of prolactin, free and total testosterone, DHEA‐S, and AM cortisol as well as normal thyroid function tests. A 24‐ h urine collection for 17‐ketosteroids and cortrosyn stimulation tests were also within normal limits. Both somatomedin C and growth hormone levels, however, were elevated, at 970 ng/mL (114‐942 ng/mL) and 41.3 ng/mL (0‐10 ng/mL), respectively, consistent with acromegaly. MRI revealed a focal pituitary mass, compatible with a primary pituitary neoplasm. The patient underwent surgical resection of the tumor, which was found to be a growth hormone‐producing pituitary adenoma.The diagnosis of Carney complex was made, due to cutaneous and mucosal lentigines, cutaneous myxomas, blue nevus, atrial myxoma, pituitary neoplasm with acromegaly, and a positive family history.
Evaluation of inflammatory parameters in physical urticarias and effects of an anti‐inflammatory/antiallergic treatment
Authors: Frezzolini Alessandra , De Pità Ornella , Cassano Nicoletta , D’Argento Vito , Ferranti Giulio , Filotico Raffaele , Vena Gino A. 
Published: March 2003

AbstractBackground  Physical urticaria (PU) includes a heterogeneous group of urticarias whose etiopathogenic aspects are still obscure and whose therapeutical management is often difficult. We have previously demonstrated the efficacy of a sequential treatment with nimesulide, a unique nonsteroidal anti‐inflammatory drug, and ketotifen in various forms of PU.Methods  The expression of some inflammatory parameters was evaluated in 10 patients affected with some forms of PU. In particular, serum levels of interleukin (IL)‐4, IL‐1β, tumor necrosis factor (TNF)‐α, adhesion molecules (sELAM, sICAM‐1 and sVCAM), soluble receptors (sIL‐2R, sCD30, sCD23) and IgE were assessed. Moreover, the cutaneous expression of IL‐1β, TNF‐α and ICAM‐1 was studied on biopsy specimens taken from nonlesional skin of patients. The same parameters were further evaluated in both skin and serum following treatment with nimesulide and ketotifen, in order to better understand the possible effects of these agents on the inflammatory network of PU.Results  Before therapy we could detect significantly higher serum levels of IL‐1β and TNF‐α (P < 0.001) and of circulating adhesion molecules in comparison with controls (sELAM, sICAM: P < 0.001; sVCAM: P < 0.02); after treatment, a significant reduction of each was observed (P < 0.05). Simultaneously, a high expression of IL‐1β, TNF‐α and ICAM‐1 was detected in all skin specimens at the baseline, with a relevant decrease following therapy.Conclusions  These results confirm the therapeutical value of treatment with nimesulide and ketotifen in PU and suggest that these agents are able to reduce the release and the expression of some inflammatory molecules that are up‐regulated in PU.
A novel sustained‐release matrix based on biodegradable poly(ester amide)s and impregnated with bacteriophages and an antibiotic shows promise in management of infected venous stasis ulcers and other poorly healing wounds
Authors: Markoishvili Kalistrat , Tsitlanadze George , Katsarava Ramaz , Glenn J. , Morris Jr. MD  , Sulakvelidze Alexander 
Published: March 2003

AbstractHealing of poorly vascularized and venous stasis ulcers is often refractory to therapy, particularly when they are infected. Systemic antibiotic therapy may be of little benefit in this setting because of poor penetration of the antibiotic into the wound and the frequent associated emergence of bacterial strains resistant to common antimicrobial agents. Given the clinical significance of these problems, there is a need to explore alternative management approaches for these difficult‐to‐treat wounds.PhagoBioDerm is a novel wound‐healing preparation consisting of a biodegradable polymer impregnated with an antibiotic and lytic bacteriophages, which was recently licensed for sale in the Republic of Georgia (one of the former Soviet Union republics). In 1999–2000, in Tbilisi, Georgia, 107 patients who had ulcers that had failed to respond to conventional therapy were treated with PhagoBioDerm alone or in combination with other interventions.The wounds/ulcers healed completely in 67 (70%) of 96 patients for whom follow‐up data were available. In 22 cases in which microbiologic data were available, healing was associated with the concomitant elimination of, or a reduction in, specific pathogenic bacteria in the ulcers.Our findings suggest that this slow‐release biopolymer is safe and of possible benefit in the management of refractory wounds, and they support the apparent utility of bacteriophages in this setting. Further studies, including carefully designed clinical trials, will be required to rigorously evaluate the efficacy of this novel wound dressing preparation.
The seroprevalence of Helicobacter pylori and nitric oxide in acne rosacea
Authors: Gürer Mehmet Ali , Erel Arzu , Erbaş Deniz , Çağlar Kayhan , Atahan Çiğdem 
Published: March 2003

AbstractBackground Acne rosacea is a dermatosis with unknown etiology. Some studies have reported a high prevalence of Helicobacter pylori infection in acne rosacea. Other studies have reported a decrease in the severity of the lesions of acne rosacea after eradication of H. pylori. H. pylori is a Gram‐negative bacterium which colonizes the gastric mucosa and increases the synthesis of oxygen radicals, such as superoxide and proinflammatory cytokines. These cytokines have been demonstrated to stimulate the synthesis of the inflammatory species nitric oxide (NO). In this study, we examined the role of NO in the possible effect of H. pylori in acne rosacea.Methods Thirty‐three acne rosacea patients were included in the study and the control group comprised 20 healthy individuals. The levels of immunoglobulin G antibodies against H. pylori in the serum samples were measured using the enzyme‐linked immunoabsorbent assay method. Measurement of nitrate was performed using chemiluminescence in accordance with the method described by Braman and Hendrix (Braman RS, Hendrix SA. Nanogram nitrite and nitrate determination in environmental and biological materials by vanadium(iii) reduction with chemiluminescence detection. Anal Chem 1989; 61: 2715–2718). For statistical analysis, the t‐test was used.Results The seropositivity of H. pylori in acne rosacea patients was found to be high; however, the serum nitrate levels were found to be normal.Conclusions The results of the study indicate that the inflammatory species NO, which has been hypothesized to be associated with H. pylori, has no role in the inflammatory mechanism of acne rosacea.