bluuebunny/crossref_metadata_2025_split huggingface dataset:
Allergen‐specific immunotherapy in dogs with atopic dermatitis and house dust mite hypersensitivity: use of symptom/medication scores
Authors: Hillier A. , Kwochka K. W. 
Published: March 2003

There is no published literature on the efficacy of allergen‐specific immunotherapy (ASIT) for dogs with atopic dermatitis (AD) and house dust mite (HDM) hypersensitivity. Symptom/medication (SM) scoring is the standard measure of clinical disease during ASIT in humans. The purpose of this study was to determine the response to ASIT in dogs with AD and HDM hypersensitivity using SM scores, and compare results with the owner’s global assessment and the investigator’s clinical evaluation. All dogs had nonseasonal AD, positive intradermal test reactions to HDM, and were treated for 12 months with ASIT that included HDM allergens. Evaluations at 0, 3, 6, 9 and 12 months included: daily owner symptom (pruritus, lesions, coat character) and medication (all anti‐inflammatory medications) scoring for 28 days; owner global assessment; and investigator clinical sign score. Occurrence of skin infections was documented throughout the study. Statistical analysis of SM scores at 0 and 12 months was performed using Student’s t‐test. Nineteen dogs completed the study. Fourteen (74%) dogs showed significant improvement (P < 0.05) in SM score. A 50% improvement in SM score, owners’ global assessment and clinical sign score was seen in 12 (63%), 17 (89%) and 10 (53%) dogs, respectively. In the first 6 months of ASIT, 17 episodes of skin infections (12 dogs) were recorded, and 13 episodes (10 dogs) in the final 6 months. The majority of dogs with AD and HDM hypersensitivity improved with ASIT. SM scores are a useful semiquantitative measure of clinical disease. Many dogs continued to have skin infections. This study was funded by the Ohio Animal Health Foundation.
Malignant blue nevus of the scalp
Authors: Calista, MD Donato , Schianchi, MD Sandra , Landi, MD Christian 
Published: March 2003

A 70‐year‐old woman had noticed, at the age of 30, a single blue nodule of about 1 cm in size on her scalp. The lesion remained stable until 1991, when it became larger and ulcerated and, because of the sudden onset of additional macules and nodules around it, the patient presented at our Dermatological Division in August 1992.Physical examination showed a blue–black plaque, 2 × 2 cm in size, on the left parietal area of the scalp, surrounded by several blue–grey pigmented nodules and macules (Fig. 1). Chest X‐ray, abdomen scan, and a total body computed tomography (CT) scan were negative for metastatic disease. A wide resection of the scalp lesion was performed. The histologic evaluation revealed a dense collection of spindled melanocytes in the dermis and in the subcutaneous fat. Nuclear and cytoplasmic pleomorphism, some mitotic figures, and necrosis foci were present (Figs 2 and 3). Pictures of cellular blue nevus were found in the surrounding lesions. Ten months later, new blue macular and papular lesions appeared in proximity to the surgical scar. The patient refused any additional surgery, and so was treated with dacarbazine (DTIC) 800 mg intravenously (every 20 days) and 2α interferon (3 million units subcutaneously, three times weekly). The growth of the lesions slowed down for a few weeks, and then increased again to become a wide, blue–black vegetating mass (Fig. 4). In June 1995, a total body CT scan revealed multiple focal nodules on the lungs and two metastatic masses on the eighth segment of the liver. A palliative polychemotherapy, with vindesin 3 mg/m2 and DTIC 400 mg/m2, was started, but did not stop the progression of the disease, and the patient died in December 1996.
The epidemiologic trends of scabies among Israeli soldiers: a 28‐year follow‐up
Authors: Mimouni Daniel , Gdalevich Michael , Mimouni Francis B. , Haviv Jacob , Ashkenazi Isaac 
Published: March 2003

Abstract Background Scabies is not a notifiable disease in most countries. Thus, the reported rates of the disease in large populations are usually inaccurate and based on estimations. Scabies is usually reported only when large outbreaks occur. Objective This article describes the global epidemiology of scabies in the Israel Defense Force. The data used in this study are based on the routine and mandatory reporting of every individual case of scabies to the Army Health Branch Epidemiology Department since 1968. Results There was a period of 13 years of quiescence from the implementation of reporting in 1968 until 1981. This period was followed by an epidemic of 15 years, peaking in 1985 and 1986, and returning to the baseline rates of the quiescent period by 1996. This prospectively observed pattern of at least 13 years of quiescence followed by a peak of 15 years is consistent with other, mostly retrospective, reports. Although the peak may have been triggered by the “Lebanon” war of 1982, it is noticeable that no peak was observed during the “Yom Kippur” war (1973). Conclusions Prospective, mandatory reporting of the kind described here should help to better understand the epidemiology of scabies.
A comparison of the efficacy of oral fluconazole, 150 mg/week versus 50 mg/day, in the treatment of tinea corporis, tinea cruris, tinea pedis, and cutaneous candidosis
Authors: Nozickova Marie , Koudelkova Věra , Kulikova Zuzana , Malina L. , Urbanowski Slawomir , Silny Wojciech 
Published: March 2003

Two hundred and forty five patients with dermatophytoses and cutaneous candidosis were enrolled in the study; 122 were randomized to the once‐weekly regimen and 123 to the once‐daily regimen. Subjects included both men and women; the average age was 42 years. There were no statistically significant differences between the two groups with regard to age, sex, race, and body weight distributions.In the group receiving once‐weekly fluconazole, there were 58 tinea pedis infections and 77 nonpedis infections (tinea corporis, tinea cruris, and cutaneous candidosis). In the group receiving once‐daily fluconazole, there were 56 tinea pedis infections and 76 nonpedis infections. The duration of infection and total score of signs and symptoms did not differ significantly between the two groups.Patients received treatment until clinically cured or up to a maximum of 6 weeks for tinea pedis and 4 weeks for tinea corporis, tinea cruris, or cutaneous candidosis. Medical history, physical and laboratory examinations, and the clinical diagnosis were recorded. Clinical and mycologic examinations and laboratory testing were performed at baseline and 2 weeks after treatment initiation, and then weekly until clinically cured or the maximum duration of treatment allowed was reached. Safety analysis was performed for all patients. Follow‐up clinical and mycologic examinations were performed 1 month after the therapy ended.The clinical efficacy was based on cure (disappearance of all baseline signs and symptoms of infection), marked improvement, moderate improvement, failure (no change or worsening of the signs and symptoms), or unevaluable (most commonly due to protocol evaluations or the absence of an identified pathogen). Mycologic efficacy was based on eradication (absence of pathogen on microscopy and/or culture), persistence (presence of pathogen on microscopy and/or culture), superinfection (absence of pathogen, but with a different fungal pathogen on microscopy and culture associated with clinical disease), or unevaluable. Long‐term follow‐up evaluation included the category relapse, defined as the absence of pathogen at the end of treatment, with the reappearance of that pathogen on microscopy and/or culture at follow‐up visit. The culture result determined the efficacy where discrepancies between microscopy and culture findings occurred.
The hyperkeratotic variant of disseminated superficial actinic porokeratosis (DSAP)
Authors: Jang Kyoung‐Ae , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung 
Published: March 2003

A 78‐year‐old South Korean man was referred to us from the Medical Intensive Care Unit (MICU) for an opinion. He was comatose and was on ventilatory care due to aspiration pneumonia. Multiple tiny papules had developed 10 years previously and since then the number and size had been increasing gradually. He had been diabetic for the past 4 years, and had Parkinson’s disease diagnosed 1 year previously. Laboratory examinations revealed an elevated level of white blood cells (WBCs) (25,000/μL) and decreased hemoglobin (8.8 g/dL). Other laboratory results were negative or within normal limits.Skin examination showed multiple, discrete, crust‐like, brownish papules over the erythematous base on the face, upper extremities, and lower extremities ( Fig. 1). With the clinical impressions of irritated verruca vulgaris, seborrheic keratosis, or cutaneous fungal infection, a skin biopsy was taken from a papule on the left shin, and histopathologic examination revealed several pronounced hyperkeratotic and parakeratotic columns, and characteristic cornoid lamellae in the stratum corneum (
Fig. 2). Beneath the cornoid lamellae, the granular layer was decreased. A number of round or oval, dyskeratotic, homogenized eosinophilic cells with pyknotic nuclei were scattered in the prickle cell layer below the cornoid lamellae (
Fig. 3). A mild lymphohistiocytic infiltrate was observed in the papillary dermis and around the blood vessels in the upper dermis. Also, actinic degeneration was present in the upper dermis.Multiple, discrete, brownish papules with peripheral keratotic ridges on the left shinimageSeveral hyperkeratotic and parakeratotic columns in the stratum corneum (hematoxylin and eosin)[TAB]imageA number of round or oval dyskeratotic homogenized eosinophilic cells with pyknotic nuclei in the prickle cell layer below the cornoid lamellae (hematoxylin and eosin)[TAB]image Discussion
Propionibacterium acnes: interaction with complement and development of an enzyme‐linked immunoassay for the detection of antibody
Authors: Burkhart Craig G. , Msph . , Cantrill John , Butcher Cynthia L. , Lehmann Paul F. 
Published: March 2003

Abstract Objective To characterize the immune response to Propionibacterium acnes in acne patients. Design Comparison of serologic responses in acne and normal patients using counterimmunoelectrophoresis for antibody and an enzyme‐linked immunosorbent assay (ELISA) to detect immunoglobulin G (IgG) antibody. Setting The serum of acne and nonacne patients from the Dermatology Clinic at the Medical College of Ohio was utilized for analysis. Results Using counterimmunoelectrophoresis, antibody was detected in 13 of 20 acne patients. The antigen was detectable as an anion in the barbital buffer at pH 8.2, strongly suggesting a carbohydrate component. By ELISA, the antibody proved to be IgG, and the bacteria and its water‐soluble fractions were capable of fixing complement. Conclusions The primary instigator of inflammation in acne vulgaris is an immunologic reaction to extracellular products of P. acnes. The immunologic response involves both humoral and cell‐mediated pathways. The antibodies to P. acnes have not been characterized fully, although they are largely of the IgG class. We have further characterized the dominant antigen to have a carbohydrate component.
Weekly vs. fortnightly intralesional meglumine antimoniate in cutaneous leishmaniasis
Authors: Mujtaba Ghulam , Mbbs . , Fcps . , Khalid Muhammad , Mbbs . , Fcps . 
Published: March 2003

One hundred and four patients with a clinical diagnosis of cutaneous leishmaniasis (CL) and a positive Giemsa‐stained smear for the parasite were recruited after informed consent into this randomized clinical trial, comparing the efficacy of weekly vs. fortnightly intralesional injections of meglumine antimoniate. Patients having more than five lesions and pregnant women were not included.The patients were randomly divided into two treatment groups. Patients in group A were treated with weekly and those in group B with fortnightly intralesional injections of meglumine antimoniate solution (each ampule of 5 mL containing 425 mg of the salt). A fine needle (0.40 × 13 mm) was used to inject the lesions. Each lesion was infiltrated from all sides until it had blanched. Generally, 1–2 mL of the solution was required for individual lesions depending upon their size. No adjuvant therapy was used.In both groups, the treatment was continued until complete cure or up to 8 weeks, whichever was earlier. Patients were followed up fortnightly for 2 months after cessation of therapy for any recurrence. Laboratory investigations, including complete blood count, serum urea and creatinine, urinalysis, and liver function tests, were carried out before and after treatment.
Disseminated cutaneous Mycobacterium chelonae infection after injection of bovine embryonic cells
Authors: Valencia Isabel C. , Weiss Eduardo , Sukenik Elizabeth , Kerdel Francisco A. 
Published: March 2003

A 50‐year‐old previously healthy white woman developed a tender erythematous draining subcutaneous nodule on her left cheek, 9 months after receiving multiple injections of bovine embryonic cells in different areas of the face, neck, and chest as a skin rejuvenation treatment. Over the subsequent 4 months, multiple similar nodules developed on the injected areas. The lesions, which were initially painful, became asymptomatic as they developed purulent drainage and ruptured onto the skin surface. There were no associated fevers, chills, or sweats. The nodules failed to respond to a 2‐month course of oral prednisone and intralesional triamcinolone acetonide.Physical examination showed red, firm, subcutaneous nodules some of which were draining a serosanguinous exudate ( Fig. 1). While a presumptive diagnosis of foreign body granuloma was made, the possibility of an atypical mycobacterial infection remained, and therefore tissue was submitted for culture. While awaiting culture results, the patient was started on minocycline, 50 mg twice daily.Neck with disseminated subcutaneous erythematous nodules due to M. chelonae that developed following injections of “bovine embryonic cells”imageThe biopsy showed a collection of chronic and granulomatous inflammatory cells, intermixed with a few areas of polymorphonuclear abscesses within the dermis ( Fig. 2). Doubly refractile foreign material was not detected. Although acid‐fast bacilli were not observed with Ziehl–Neelsen stain, tissue culture grew mycobacterial colonies after 1 week of incubation. The isolate was subsequently identified as Mycobacterium chelonae, and clarithromycin, 500 mg twice daily, was added to the antimicrobial regimen on the basis of the susceptibility profile. There was significant improvement and the lesions resolved clinically over the following 6 weeks.Skin biopsy specimen from facial nodule shows granulomatous inflammation within the papillary dermis (hematoxylin and eosin, ×40)image
Prevalence of cutaneous manifestations in 200 patients with eating disorders
Authors: Glorio Roberto , Allevato Miguel , De Pablo Ana , Abbruzzese Mario , Carmona Luz , Savarin Mario , Ibarra Monica , Busso Corina , Mordoh Ana , Llopis Carolina , Haas Roxana , Bello Mabel , Woscoff Alberto 
Published: March 2003

Abstract Background Eating disorders are increasing and show a variety of symptoms. They mainly include anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not specified (EDNOS). They predominate in females and represent an important danger, especially in teenagers. In serious cases, they may be life‐threatening. Objective To determine the prevalence of cutaneous findings in patients with eating disorders and to compare the results with those found in the literature. Methods An observational, transverse, and prospective study was performed. Two hundred patients of recent admission to ALUBA (association that fights against BN and AN), a psychiatric unit for eating disorders, were included: 122 BN; 62 AN; 16 EDNOS. Results Patients with eating disorders show dermatologic manifestations (alopecia, xerosis, hypertrichosis, caries, nail fragility) that are secondary to starvation. Russell's sign, seen as calluses on the dorsal aspect of the hands, is a consequence of self‐induced vomiting and the local trauma of the superior incisors. This sign represents a compensatory behavior to overeating and predominates in the BN group. Conclusion The recognition of dermatologic signs could be of immense value and could lead to the early diagnosis and treatment of these eating disorders.
Frequency of oral conditions in a dermatology clinic
Authors: Ramírez‐Amador Velia A. , Esquivel‐Pedraza Lilly ,   DDS, Orozco‐Topete Rocío 
Published: March 2003

Abstract Background Oral mucosal manifestations may be the initial feature, the most florid clinical feature, or the only sign of mucocutaneous diseases. Methods Sixty adult patients (48 women, 12 men) with oral mucous complaints were referred to and evaluated at a dermatology clinic in a tertiary care hospital in Mexico City between November 1996 and September 1998. Results The most frequent oral conditions observed were pemphigus vulgaris (18.3%), lichen planus (8.3%), candidiasis (8.3%), recurrent aphthous ulcers (6.7%), herpetic lesions (6.7%), xerostomia (6.7%), and traumatic lesions (6.7%). Oral affection in mucocutaneous conditions was observed in 21 (35%) patients; the diagnosis was based on oral signs in 10 (48%) of these patients. A large number of oral conditions had previously been misdiagnosed. Conclusions The importance of the diagnosis of oral conditions in dermatology has been underlined in this study due to the frequency and diversity of oral lesions. The benefits of an interdisciplinary approach in the management of patients has been highlighted.
Cutaneous angiosarcoma afflicting the lower aspect of the left leg in an elderly woman
Authors: Huber Margit A. , Weber Lutz , Kaskel Peter , Warszawski Antje , Schmidt Roland , Peter Ralf U. , Krähn Gertraud 
Published: March 2003

An 88‐year‐old woman who was generally in good health was referred to the Dermatology Department in August 1997. Three years prior to admission she had first noticed a bluish macule on her left lower leg which had rapidly enlarged over the past 3 months. Other symptoms included intermittent bleeding and pain. On examination, there was an exophytic and partly exulcerated tumor of approximately 9 × 7 cm in diameter, located above the left medial malleolus. The remainder of the lower aspect of the left leg was without pathologic findings. The patient had not undergone surgery or radiotherapy prior to the described symptoms.Blood hematology, chemistry, immunologic and serologic parameters (including liver function tests) were within the normal range. The alkaline phosphatase decreased from 211 U/L initially to 179 U/L. Magnetic resonance imaging (MRI) of the left lower leg revealed a 10 × 5 × 2 cm tumor mass invading the subcutaneous fat, leaving muscle tissue. Ultrasound of the regional lymph nodes, a chest X‐ray, and a full‐chest computed tomography (CT) scan were normal. A biopsy specimen showed a marked proliferation of cells of undifferentiated morphology in the corium and subcutaneous tissue. Several layers of atypical endothelial cells next to large cuboid cells with pleomorphic nuclei and frequent mitoses were noted, thus facilitating clear differentiation from Kaposi’s sarcoma ( Fig. 1). Immunohistochemical studies were positive for factor VIII‐related antigen, ulex europaeus I, CD31, and CD34. An angiosarcoma was diagnosed.biopsy specimen showing marked proliferation of atypical endothelial cells in the corium and subcutaneous tissueimageTreatment included a complete surgical excision of the tumor with a wide safety margin of normal tissue. The skin defect was covered with mesh‐graft. At this point, the patient refused consent to adjuvant radiation therapy postoperatively.In January 1998 and in March 1998 recurrences of the tumor were again treated with local excision and mesh‐graft. Subsequent to multifocal recurrence in June 1998 ( Fig. 2A), the patient finally accepted palliative radiotherapy. Fractionated irradiation (total dose/left lower leg: 50 Gy; single fraction dose/left lower leg: 2 Gy; 6 MV photons) resulted in local control of the lesion for more than 6 months. In January 1999, another local recurrence of the tumor was treated with the cw‐Nd:YAG laser technique as it was not possible to conduct a second course of radiation therapy. Only 1 month later the patient presented again with multifocal spread involving most of the left lower leg (
Fig. 2B). Considering the patient's age and nursing circumstances, an above‐knee amputation of the left leg was performed.Multifocal recurrence in June 1998. (B) Progression of the disease with ulceration in February 1999image
Frequency of toenail onychomycosis in patients with cutaneous manifestations of chronic venous insufficiency
Authors: Del Mar María , De Ocariz Sáez , Arenas Roberto , Ranero‐Juárez Guadalupe Alejandra , Farrera‐Esponda Fernando , Monroy‐Ramos Elena 
Published: March 2003

AbstractBackground Chronic venous insufficiency (CVI) can originate onychopathyper se. We have anecdotally observed nail changes in patients with CVI, but there are few studies which determine the frequency of both onychopathy and onychomycosis in these patientsObjective The aim of the study was to determine the frequency of nail pathology and onychomycosis in patients with CVIPatients and Methods We included 36 adult patients, both men and women, aged from 18 to 59 years, with clinically documented venous leg ulcers. All patients were examined by a dermatologist and the venous leg ulcers were classified according to severity in three grades. The nail changes were described and a mycological examination was performed. We obtained a small fragment of the nail for histological examination. In 27 patients, we also performed functional studies to determine the type of venous insufficiency.Results The ratio of women to men was 5 : 1. The mean age of patients was 46.39 ± 8.51 years, men being slightly younger than women. Ten patients had ulcers of grade I severity, 12 had grade II, and 14 had grade III. The overall time of evolution of the cutaneous lesions was 11.02 ± 10.11. Fourteen patients had superficial venous insufficiency, whereas 13 had deep venous insufficiency. Twenty‐two (61.11%) of our patients had nail alterations. These nail changes were related more to the type of vascular affection than with the severity of cutaneous involvement. In more than half of the cases (59.09%), onychomycosis was the cause of the nail changes. The overall frequency of onychomycosis was 36.11%. The etiologic agent of onychomycosis was isolated in 38.46% of the cases, andTrichophyton rubrumwas the most frequent agent. The histologic examination of the nail plate showed a low sensitivity (62%) but a high specificity (100%) in the detection of nail plate parasitization. No clinical differences could be established between the nail changes observed in patients with true onychomycosis and those with nonfungal onychopathy.Conclusions Nail changes are common in patients with venous leg ulcer, and onychomycosis accounts for slightly more than half of the cases. We therefore recommend a routine mycological examination in patients wit nail changes and cutaneous manifestations of CVI, to diagnose or rule out onychomycosis, and therefore avoid overtreating patients without onychomycosis with antimycotics.