bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depigmentation of the normally pigmented patches in universal vitiligo patients by cryotherapy
Authors: Radmanesh Mohammed 
Published: March 2003

AbstractBackground Complete depigmentation may occur, albeit rarely, in patients with universal vitiligo. They usually have one or more pigmented patches that remain normal, most frequently over the malar area of the face and dorsal aspects of forearms. Total repigmentation may not occur in these patients, even after receiving 150 session of PUVA therapy alone or in conjunction with other medical or surgical procedures, and there is possibility of recurrence after cessation of therapy. These patients are usually more interested in depigmentation rather than trying for repigmentation.Objective Because of the relatively high sensitivity of melanocytes to cryotherapy and the possibility of isomorphic phenomenon in vitiligo patients, removal of the remaining normally pigmented patches was attempted in patients with universal vitiligo using cryotherapy.Method Five volunteer patients with universal vitiligo were chosen, all of whom wished to have their pigmented patches removed. In all five patients a small area was tested first in order to assure the patients of what the procedure involved and to show its likely result. All pigmented areas were then treated to 1–3 sessions of cryotherapy using a closed contact CO2 cryogun, with 4–6‐week intervals.Results Complete and permanent depigmentation was achieved in all five patients with excellent cosmetic results and no complications or scarring.Conclusion Cryotherapy is a cost effective, non‐complicating, easily available procedure which can be used for depigmentation of normally pigmented patches in patients with universal vitiligo.
Isolated granulocytic sarcoma of the skin in an elderly patient: good response to treatment with local radiotherapy and low‐dose methotrexate
Authors: Pulsoni Alessandro , Falcucci Paolo , Anghel Gabriel , Ribersani Michela , Petrucci Maria Teresa , Pescarmona Edoardo , Muscardin Luca 
Published: March 2003

AbstractGranulocytic sarcoma of the skin is frequently associated with haematological diseases and is rarely isolated. The disease generally develops into acute systemic myeloid leukaemia and is associated with a poor prognosis. We report an elderly patient presenting isolated granulocytic sarcoma of the skin who showed a very good response to treatment with local radiotherapy and low‐dose methotrexate.
Intratracheal metastasis from malignant melanoma
Authors: Koyi Hirsh , Brandén Eva 
Published: March 2003

AbstractMalignant melanoma is increasing in incidence in most countries. Distant metastases are common but intratracheal metastasis is extremely rare. We report a 54‐year‐old man who presented with increasing dyspnoea. Symptomatic treatment for asthma had been of no effect. Bronchoscopy showed that trachea was nearly occluded by a tumoral mass, and biopsy proved this to be a metastasis of malignant melanoma. The man’s breathing difficulties disappeared after local laser therapy, but 2 months later he presented with symptoms of multiple brain metastases.
The Merkel cell carcinoma: survival and oncogene markers
Authors: Jemec B , Chana J , Grover R , Grobbelaar Ao 
Published: March 2003

AbstractBackground Merkel cell carcinoma (MCC) is a rare and malignant tumour. Survival data and prognostic factors are scarce.Aim To investigate the usefulness of biological markers to predict the prognosis for these aggressive tumours.Methods C‐myc oncoprotein and proliferation was analysed in specimens from 13 patients with MCC, treated between 1983 and 1997. The average age at presentation was 68.3 years. Overall follow‐up ranged from 14 to 158 months, with a mean of 68.2 months. Specimens were analysed by immunohistochemistry for proliferation (mib‐1) and flow cytometry for oncogene activity (c‐myc).Results The median positivity was 52% for the c‐myc oncogene and 50% for proliferation, but these did not correlate to survival as analysed by the Kaplan–Meier method. Other parameters such as median age at presentation, sex, site of tumour and adjuvant radiotherapy were also analysed, but none were found to be significant.Conclusions This study showed that neither c‐myc oncogene activity or mitotic index in MCC can be related to patient survival.
Familial erythromelanosis follicularis and chromosomal instability
Authors: Tüzün Y , Wolf R , Tüzün B , Özdemir M , Demirkesen C , Deviren A , Kotogyan A 
Published: March 2003

ABSTRACTWe report a 17‐year‐old male patient with erythromelanosis follicularis faciei et colli (EFFC), oral leucokeratosis and diabetes mellitus without islet cell antibody. His sister also had minimal findings of EFFC and minimal follicular papules on her shoulders and extensor surfaces of the arms. The father had only fine follicular papules, but no erythromelanosis. Skin and mucous membrane lesions of the proband were investigated histopathologically. Interestingly, in peripheral lymphocyte cultures of the family members, chromosomal breakage was not observed spontaneously, but it was seen with nitrogen mustard, although this disease may be of autosomal recessive inheritance. Thus, we suggest that EFFC may be a polyaetiological disorder (i.e. familial and environmental) and might be considered one of the chromosomal instability syndromes.
Personality dimensions of sexually transmitted disease repeaters assessed with the Millon Clinical Multiaxial Inventory
Authors: Bjekíc M , Lecic‐Toševski D , Vlajinac H , Marinkovíc J 
Published: March 2003

AbstractObjective To assess the personality characteristics of patients with repeated sexually transmitted diseases (STD).Method A case–control study comparing 101 STD repeaters (subjects with a lifetime history of three or more STDs) with 182 controls who had no history of STD. All subjects attended the City Department for Skin and Venereal Diseases in Belgrade (Yugoslavia) from June 1997 to April 1998. Personality characteristics was assessed by the Millon Clinical Multiaxial Inventory (MCMI).Results The analysis of MCMI test showed that STD repeaters had higher scores on narcissistic, antisocial and paranoid scales. The difference between STD repeaters and the controls was significant on antisocial, psychotic thinking and psychotic delusion scales, although scores on clinical syndromes were low for both cases and controls. Discriminant analysis showed that antisocial personality was predictive for STD repeaters.Conclusions This study support the hypothesis that STD repeaters are different from controls in terms of their psychological characteristics. The behaviour of STD repeaters is ego–syntonic, which makes the treatment of their personality difficult and emphasizes the importance of work on primary and secondary prevention of STD.
The importance of accurate dosage of topical agents: a method of estimating involved area and application to calcipotriol treatment failures
Authors: Osborne JE , Hutchinson PE 
Published: March 2003

AbstractLittle attention is given to accurate dosage of topical medication which is a potential source of side‐effects and treatment failure. There are studies on the dosage for ‘sparing’ application relevant to topical steroids but not for ‘liberal’ application. Though calcipotriol is a first line topical treatment for psoriasis, approximately one‐third of patients do not respond adequately. The aims of the present study were to define liberal dosage, to develop a method of calculation of area of involved skin and to evaluate the efficacy of calcipotriol in optimized liberal dosages, based on preliminary studies, in calcipotriol treatment failures. Weight/unit area of ointment and cream base, constituting liberal application, was determined in six normal volunteers. The area of psoriatic involvement in 24 calcipotriol non‐responders was estimated by a ‘fill‐up’ method and a modified ‘hand’ method. The results of the two methods were similar (Pearson correlation coefficient 0.68, P < 0.0001) but the ‘hand’ method proved easier in use and was the preferred method for the rest of the study. The patients applied calcipotriol at their accustomed rates for at least 2 weeks and then at the calculated liberal rates, using cream in the morning and ointment at night, for 4 weeks. The efficacy measures were Psoriasis Area and Severity Index (PASI) (primary measure), a four‐point efficacy score and a visual analogue scale. As a result of the preliminary study and the actual amounts used by the patients in the psoriasis treatment study reported below, liberal application has been defined as 50 g/m2 per application for ointment base and 40 g/m2 per application for cream. At this dosage, an average individual would use ≈ 100 g of medication/week to treat 10% of the body surface. During the 4‐week treatment study, the psoriasis patients used an average of 39 g (SD 17 g)/m2 per application of cream and 52 g (SD 13 g)/m2 per application of ointment. All efficacy measures showed marked improvement (P < 0.0001). The frequency distribution of the PASI reduction defined responsive (70% of patients) and poorly responsive groups (30%), with mean PASI reduction of 60% and 17%, respectively.
Pre‐operative diagnosis of pigmented skin lesions: in vivo dermoscopy performs better than dermoscopy on photographic images
Authors: Carli P , De Giorgi V , Argenziano G , Palli D , Giannotti B 
Published: March 2003

AbstractBackground Epiluminescence microscopy (ELM) (dermoscopy, dermatoscopy) is a technique for non‐invasive diagnosis of pigmented skin lesions that improves the diagnostic performance of dermatologists. Little is known about the possible influence of associated clinical features on the reliability of dermoscopic diagnosis during in vivo examination.Objective To compare diagnostic performance of in vivo dermoscopy (combined clinical and dermoscopic examination) with that of dermoscopy performed on photographic slides (pure dermoscopy).Design This case series comprised 256 pigmented skin lesions consecutively identified as suspicious or equivocal during examination in a general dermatological clinic. Clinical examination and in vivo dermoscopy were performed before excision by two trained dermatologists. The same observers carried out dermoscopy on photographic slides at a later time, and these three diagnostic classifications were reviewed together with the histological findings for the individual lesions. This was carried out in a university hospital.Results In vivo
dermoscopy performed better than dermoscopy on photographic slides for classification of pigmented skin lesions compared with histological diagnosis, and both performed better than general clinical diagnosis.
In vivo
dermoscopic diagnosis of melanoma showed 98.1% sensitivity, 95.5% specificity and 96.1% diagnostic accuracy while dermoscopic diagnosis of melanoma on photographic slides was less reliable with 81.5% sensitivity, 86.7% specificity and 85.2% diagnostic accuracy. In particular, diagnosis of melanoma based on photographic slides led to nine false negative cases (three
in situ , six invasive; thickness ranges 0.2–1.5 mm).Conclusions In vivo
dermoscopy, i.e. combined clinical and dermoscopic examination, is more reliable than dermoscopy on photographic slides. In clinical practice, therefore,
in vivo dermoscopy cannot be considered independent from associated clinical characteristics of the lesions, which help the trained observer to reach a more precise classification. This may have implications on the reliability of ELM diagnosis made by an observer not fully trained in the clinical diagnosis of pigmented skin lesions or by a remote observer during digital ELM teleconsultation.
The link between Helicobacter pylori infection and rosacea
Authors: Szlachcic A 
Published: March 2003

AbstractBackground Rosacea is a common condition of unknown aetiology that is usually accompanied by gastrointestinal symptoms and responds favourably to treatment with antibiotics.Aims/methods This study was designed to examine the prevalence of gastric Helicobacter pylori (Hp) infection verified by 13C‐UBT, CLO‐test, Hp culture and serology (IgG and IgA) and the presence of Hp in the oral cavity evidenced by CLO‐test, Hp culture and saliva anti‐Hp antibodies (IgG and IgA). During gastroduodenoscopy antral and fundic biopsy samples were taken for histological evaluation (the Sydney system). This study was performed on 60 subjects 30–70 years old with visible cutaneous rosacea symptoms and 60 age‐ and gender‐matched controls without skin diseases but with dyspeptic symptoms similar to those of rosacea and without endoscopic changes in gastroduodenal mucosa (non‐ulcer dyspepsia – NUD).Results The Hp prevalence in rosacea patients was about 88%, compared to 65% in the NUD controls. A noticeable number of rosacea patients showed chronic active gastritis predominantly in antrum but also in the corpus while those with NUD showed only mild gastritis confined to the antrum only. Following the initial examination, a typical 1 week systemic anti‐Hp therapy, including omeprazole (2 × 30 mg), clarithromycin (2 × 500 mg) and metronidazole (2 × 500 mg), plus gargling and application of metronidazole paste in the case of Hp oral cavity infection. After the application of the systemic and local therapy in the oral cavity, Hp was eradicated from the stomach in 97% and from the oral cavity in 73% of treated patients. Within 2–4 weeks, the symptoms of rosacea disappeared or decreased markedly in 51 subjects.Summary We conclude that: (1) rosacea is a disorder with various gastrointestinal symptoms closely related to gastritis, especially involving the antrum mucosa; (2) the eradication of Hp leads to improvement of symptoms of rosacea and reduction in related gastrointestinal symptoms; (3) the lack of improvement of cutaneous symptoms in rosacea after eradication of Hp from the gastric mucosa could depend on bacteria in the oral cavity; and (4) rosacea could be considered as one of the extragastric symptoms of Hp infection probably mediated by Hp‐related cytotoxins and cytokines.
Pemphigus vulgaris: a review of treatment over a 19‐year period
Authors: Ljubojević S , Lipozenčić J , Brenner S , Budimčić D 
Published: March 2003

ABSTRACTBackground Pemphigus vulgaris is an autoimmune blistering disease of the skin and mucous membranes with a high mortality if left untreated.Objective We present a retrospective analysis of 159 patients with pemphigus vulgaris and pemphigus vegetans who were admitted to the Department of Dermatology and Venereology, Zagreb University Hospital Center (Zagreb, Croatia) from 1980 to 1998.Results Female to male ratio was approximately 2 : 1. The mean age was 53 years. During the war years in Croatia (1991–95) we noticed a low incidence of pemphigus vulgaris, and from 1996 to 1998 the incidence almost doubled. Diagnosis was based on histopathology [showing typical pemphigus vulgaris changes in 156 (98%) patients], indirect immunofluorescence [positive in 122 (77%) patients], direct immunofluorescence [positive in 141 (89%) patients], and blister smear cytology (Tzanck test) [positive in 115 (72%) patients]. High dosages of prednisone (100–150 mg) were given to 129 patients, which was combined with azathioprine. Patients with refractory pemphigus vulgaris were treated with intramuscular gold (14 patients) and plasmapheresis (five patients). All patients were treated with local ointments. The prolonged use of high doses of corticosteroids and immunosuppressants caused several complications, in particular, steroid diabetes (37 patients), skin infections (26 patients), arterial hypertension (23 patients), cardiorespiratory diseases (22 patients), sepsis (nine patients), etc. During the hospital treatment, 14 patients died, 10 during 1980–89 and only four during the 1990–98 period. The main causes of death were cardiorespiratory failure (six patients) and sepsis (five patients).Conclusions Although pemphigus vulgaris is still a life‐threatening disease, today it can be successfully treated with a combination of immunosuppressive agents. Early diagnosis and treatment of pemphigus vulgaris allow a better prognosis with lower mortality rates.
Pretibial myxoedema associated with Hashimoto's thyroiditis
Authors: Cannavò SP , Borgia F , Vaccaro M , Guarneri F , Magliolo E , Guarneri B 
Published: March 2003

ABSTRACTPretibial myxoedema is a cutaneous mucinosis typically associated with Graves’ disease, although it may also develop in subjects with non‐thyrotoxic thyroid pathologies. This report presents a rare case of pretibial myxoedema occurring in a 58‐year‐old woman with biopsy‐proven Hashimoto's thyroiditis. The hypothetical pathogenetic link between the two disorders is discussed with particular attention to the role of thyroid stimulating hormone receptor antibodies.
Onychomycosis: strategies to improve efficacy and reduce recurrence
Authors: Gupta Ak , Baran R , Summerbell R 
Published: March 2003

ABSTRACTFungal infections may be difficult to treat for several reasons. It is important to obtain the correct diagnosis, and select the appropriate antifungal agent and route. General considerations that may be associated with recurrent infections are, a genetic predisposition and suboptimal bioavailability of drug, resulting in insufficient concentration at the target site. The aetiologic organism, the severity of disease, other coexisting diseases, concomitant drug intake, and the presence of fungal infection at other sites are some factors that determine the choice of antifungal therapy and its route of administration, oral vs. topical lacquer. Local factors such as the thickness of the nail, presence of lateral onychomycosis, longitudinal spike, dermatophytoma and severe onycholysis are some factors that may determine the choice of secondary measures such as mechanical or topical treatment. Booster or supplemental therapy may be of benefit when the response to initial treatment is poorer than expected and unlikely to result in complete response. Steps should be taken to reduce the possibility of recurrence once cure has been achieved.
Bullous eosinophilic cellulitis (Wells’ syndrome) associated with Churg–Strauss syndrome
Authors: Schuttelaar M‐LA , Jonkman MF 
Published: March 2003

ABSTRACTWe report a patient with Churg–Strauss syndrome (CSS) with asthma, eosinophilia, nasal polyposis and ANCA‐associated multisystem vasculitis, who's skin eruption started with erythematous urticarial‐plaques followed by haemorrhagic bullae. Histology of the plaques revealed ‘flame figures’ in the dermis with no granulomatous or vasculitic process, consistent with the diagnosis of eosinophilic cellulitis or Wells’ syndrome. The association of CSS and Wells’ syndrome observed in this patient may have a common pathogenesis. CSS may induce Wells’ syndrome by an unknown factor.
Annual Primary Health Care Contacts by People with Intellectual Disabilities: a Comparison of Three Matched Groups
Authors: Halstead Simon M. , Bradley Frances , Milne Steven , Wright Elaine C. , Hollins Sheila C. 
Published: March 2003

AbstractThe use of primary care services by three matched groups of people with intellectual disabilities was compared over a period of one year. Differences in the patterns of provision were detected between hospital intellectual disability specialists and general practitioners. The degree of behavioural disturbance and disability of the subjects were found to be the most important predictors of primary care contact.
Cognitive–Behavioural Treatment of Anger Intensity among Offenders with Intellectual Disabilities
Authors: Taylor John L. , Novaco Raymond W. , Gillmer Bruce , Thorne Ian 
Published: March 2003

Background  Aggressive behaviour has been identified as a significant problem amongst people with intellectual disabilities living in institutional settings. Anger is a key activator of aggressive behaviour, as well as being an important element of clinical distress related to adverse life experiences. There is some evidence for the value of cognitive–behavioural treatments for anger problems with people having intellectual disabilities. No controlled studies of anger treatment involving intellectually disabled offenders living in secure settings have been conducted to date. A pilot study of an elaborated anger treatment protocol for this client population was undertaken, comparing the specialised anger treatment with routine care.Methods  Detained men with intellectual disabilities and histories of offending were allocated to specially modified cognitive–behavioural anger treatment (n = 9) or to routine care waiting‐list control (n = 10) conditions. Eighteen sessions of individual treatment were delivered over a period of 12 weeks. Treatment outcome was evaluated by participants' self‐report of anger intensity to an inventory of provocations and by staff‐ratings of the anger attributes of participants' ward behaviour.Results  Participants' reported anger intensity was significantly lower following the anger treatment, compared to the routine care wait‐list condition. There were largely no treatment condition effects in staff‐rated anger. Limited evidence for the effectiveness of anger treatment was provided by the staff ratings of participant behaviour post‐treatment.Conclusions  Detained offenders with intellectual disabilities can benefit from intensive individual cognitive–behavioural anger treatment. Further research is required to examine the mechanisms for change and their sustainability.
A Randomized Controlled Trial of the Efficacy of a Cognitive‐Behavioural Anger Management Group for Clients with Learning Disabilities
Authors: Willner Paul , Jones Jessica , Tams Rachel , Green Gill 
Published: March 2003

Background  Fourteen clients with learning disabilities referred for anger management were randomly assigned to a treatment group and a waiting‐list control group.Methods  Treatment consisted of nine 2‐h group sessions, using brainstorming, role‐play and homework. Topics addressed included: the triggers that evoke anger; physiological and behavioural components of anger; behavioural and cognitive strategies to avoid the build‐up of anger and for coping with anger‐provoking situations; and acceptable ways of displaying anger (assertiveness). The intervention was evaluated using two inventories of anger‐provoking situations, which were completed independently by both clients and carers.Results  Clients in the treated group improved, on both self‐ and carer‐ratings, relative to their own pre‐treatment scores, and to the control group post‐treatment. The within‐group improvement corresponds to a ‘moderate’ (0.68 SD) effect size, whereas the between‐group improvement corresponds to a ‘large’ (1.76 SD) effect size. The degree of improvement during treatment was strongly correlated with Verbal IQ. Clients in the treated group showed further improvement relative to their own pre‐treatment scores at 3‐month follow‐up.Conclusions  The treatment was effective in decreasing anger, in this randomized controlled trial of routine clinical practice.