bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erythroderma: a clinico‐etiologic study of 90 cases
Authors: Pal, MCPS, FCPS Sabrina , Haroon, FRCP, FCPS Tahir Saeed 
Published: March 2003

Background The difficulty with erythroderma lies in finding the underlying cause. Almost all the published original clinical series of erythroderma originate from western countries. Our aim was to evaluate various causes of exfoliative dermatitis in our community and compare the findings with previous studies. Methods Ninety patients with erythroderma of either sex and any age, were studied at the Dermatology Department, Mayo Hospital, Lahore, Pakistan, between April 1992 and May 1995. A thorough clinical examination and relevant laboratory investigations, including skin biopsies, were performed. Results The mean age of onset was 41.6 years with a male : female ratio of 2.8 : 1. The onset was acute in 69% of patients. The salient features included nail changes (80%), mucosal involvement (36.6%), alopecia (30%), islands of normal skin (14.4%), and the “deck chair sign” (5.5%). The most frequent cause of erythroderma was pre‐existing dermatoses (74.4%), including psoriasis (37.8%), dermatitis (12.2%), ichthyoses (7.8%), and pemphigus foliaceus (5.6%). Drugs and malignancy each induced erythroderma in 5.5% of cases. No cause could be found in 14.6% of cases. Conclusions Etiologically, pre‐existing dermatoses showed the highest incidence and drugs the lowest compared with previous studies. Dermatitis was less common. There was a greater variety of causes of erythroderma in our series. Hair and nails were more frequently involved. Mucosal involvement, not mentioned in other studies, was present in 36.6% of our cases. The “deck chair sign” and islands of normal skin were seen in dermatoses not reported previously.
Jaipur block in postherpetic neuralgia
Authors: Bhargava Rishi , Bhargava Sudha , Haldia Kailash N. , Bhargava Puneet 
Published: March 2003

Abstract Background Postherpetic neuralgia, a common sequele to herpes zoster infection, is a chronic debilitating problem. The available therapeutic modalities are usually ineffective. Methods A total of 3960 patients (1326 women and 2634 men; age group, 21–84 years), with postherpetic neuralgia as the presenting complaint and with pain lasting from 2 months to 5 years, were treated with Jaipur block, consisting of local subcutaneous infiltration of 2% xylocaine, 0.5% bupivacaine, and 4 mg/mL dexamethasone solution. Patients were followed up at six‐weekly intervals with subsequent injections given in non‐responders. Results Twenty eight per cent of patients obtained complete relief from pain after a single injection, another 57% after a second injection, and 11% after a third injection; 4% of patients did not respond to treatment. The non‐responders were either old (over 60 years) or had pain lasting for more than 2 years. The response to therapy was similar in both sexes. There were 31 left‐handed patients in this study. Pain was less severe in left‐handed patients and they obtained complete relief after a single injection. Side‐effects including giddiness and sweating were seen, occasionally, in a few patients. Conclusions Ninety six per cent of patients obtained complete relief after the block with a follow‐up of up to 19 years.
Eosinophilic ulcer of oral mucosa
Authors: Chung Hae‐Shin , Kim Nam Soo , Kim Young Bae , Kang Won Hyoung 
Published: March 2003

A 41‐year‐old woman was seen for the examination of a painless lesion on the posterior hard palate of 2 weeks’ duration. She had no systemic symptoms. Examination of the hard palate showed a single 1 × 1 cm, round, punched out ulcer with an erythematous base; the margins of the ulcer were slightly raised and indurated ( Fig. 1). Other clinical findings were normal and laboratory study of a cutaneous biopsy showed necrotic ulceration with dense inflammatory cell infiltration. An extensive inflammatory cell infiltration with predominantly eosinophilic cells was present throughout the submucosa. A single application of liquid nitrogen decreased the lesion.Ulcer found on the posterior hard palate at the time of initial visitimage
Pustular eruption in a malaria patient treated with chloroquine
Authors: Goihman‐Yahr Mauricio 
Published: March 2003

AbstractA 42‐year‐old Thai woman with Plasmodium vivax malaria was treated with a total dose of 1800 mg of chloroquine phosphate over 6 h. Acetaminophen was administered to reduce fever. The patient awoke the next morning with diffuse macular erythema, studded with 1–2 mm vesicles and pustules, predominantly on the face and the extremities (
Fig. 1). Some pustules were follicular. The mucous membranes, palms, and soles were unaffected. A gram stain of the pustule contents showed only scattered neutrophils. A skin biopsy from a lesion on the upper leg showed the features of a drug‐induced pustular eruption: cell‐poor subepidermal blisters with scattered subcorneal pustules (
Fig. 2), mild spongiosis, and a sparse infiltrate of neutrophils and eosinophils in the papillary dermis.
1 A urine screen (Lignin test) for sulfonamides was negative, and high pressure liquid chromatography analysis of the serum showed no sulfadoxine. Hematolgy and biochemistry values, erythrocyte sedimentation rate, and glucose 6‐phosphate dehydrogenase levels were normal. Serologies for mycoplasma antibody, Herpes simplex immunoglobulin M (IgM) and IgG, cytomegalovirus IgM, anti‐human immunodeficiency virus, venereal disease research laboratory test, antinuclear antibody, alpha‐fetoprotein, and carcino‐embryonic antigen were negative. A hepatitis B panel, serum pregnancy test, and three sets of blood cultures were negative. A chest X‐ray was normal. The patient was in otherwise good health and had no history of skin diseases. Chloroquine was discontinued and the eruption quickly resolved with mild desquamation.Erythematous macules studded with small pustules (arrows) on the upper legsimageBiopsy specimen from a lesion on the leg contains cell‐poor subepidermal blisters and subcorneal pustules (arrows) (hematoxylin and eosin, original magnification, ×400)image
A clinico‐etiologic correlation in tinea capitis
Authors: Jahangir Mohammad , Hussain I. , Khurshid K. , Haroon T. S. 
Published: March 2003

Abstract Background Tinea capitis is a dermatophytosis with diverse clinical manifestations. The causative fungi of tinea capitis vary with geography and time. This study aimed to identify the etiologic agents and to determine the clinico‐etiologic correlation of tinea capitis in Lahore, Pakistan. Methods From clinically suspected cases of tinea capitis, skin scrapings and hair samples were taken and subjected to microscopy and culture. Results Of 100 evaluable patients, 95% were children below 12 years of age with almost equal sex incidence. Noninflammatory and inflammatory lesions were seen in 56.4% and 43.6%, respectively. Trichophyton violaceum was the most common etiologic agent, responsible for 82% of infection, followed by T. tonsurans (8%), T. verrucosum (5%), and T. mentagrophytes (5%). Conclusions
T. violaceum is the predominant pathogen causing tinea capitis in this part of the world, and gives rise to a varied clinical picture.
Occupational allergic contact dermatitis from unsaturated polyester resin in a car repair putty
Authors: Kanerva Lasse , Estlander Tuula , Alanko Kristiina , Pfäffli Pirkko , Jolanki Riitta 
Published: March 2003

Abstract Background Unsaturated polyester (UP) resins are widely used as cements in car repair painting to produce a smooth surface before the final painting. We report two car painters with hand and face dermatitis who were sensitized to a UP resin used for car repair cements. Methods Patch testing with commercial substances and ingredients and extracts from UP resins was used to verify the sensitivity. Results Both patients showed an allergic patch test reaction to a UP resin. They also had an allergic patch test reaction to diethyleneglycol maleate (DEGM), an extract of a UP resin. Conclusions Both patients had been patch tested elsewhere with negative results because UP resins had not been used for patch testing. Accordingly, patients with dermatitis who have been exposed to UP resins need to be patch tested with UP resins. The specific chemical causing allergic contact dermatitis in our patients was DEGM.
Xeroderma pigmentosum in black South Africans
Authors: Jacyk Witold K. 
Published: March 2003

Abstract Background Xeroderma pigmentosum occurs in all races. There is little information on its clinical picture, frequency, and types of malignant lesions in individuals of African negroid extraction. Methods Fifteen black South African patients, aged from 10 months to 21 years, with xeroderma pigmentosum were prospectively studied. Detailed dermatologic, ophthalmologic, and neurologic examinations were carried out in all patients. Cutaneous, conjunctival, and lingual malignant lesions were histologically assessed. Complementation studies were not performed. Results Twelve patients had cutaneous malignancies, predominantly squamous carcinomas, usually several at one time. Carcinomas of the tip of the tongue occurred in five patients and conjunctival carcinomas in four. Cutaneous and mucosal carcinomas developed at an earlier age than in the series from other parts of the world. Three patients had extensive skin involvement characteristic of xeroderma pigmentosum, but did not develop malignancies. They most likely belong to a complementation group(s) with higher rates of unscheduled deoxyribonucleic acid (DNA) synthesis. Conclusions Xeroderma pigmentosum in South African black people is characterized by the very early development of cutaneous, ocular, and tongue squamous cell carcinomas and usually has a rapid and devastating course.
Bockhart’s impetigo: complication of waterbed use
Authors: Hsu Sylvia , Halmi Bill H. 
Published: March 2003

A 30‐year‐old black man with no relevant past medical history presented with a 2‐day history of a mildly pruritic eruption that began on his legs and spread to his trunk. He stated that he awoke with the eruption on his legs after he had slept on a waterbed. He had experienced profuse sweating because of the plastic bedcover. He denied any medical problems. Specifically, he had no fever or chills. He also denied taking any medications or applying any topical agents to his skin.On physical examination, the patient appeared to be a healthy black man who had hundreds of 1‐mm, white‐to‐yellow pustules on his back ( Fig. 1) and proximal, posterior extremities
(
Fig. 2). His face, scalp, mucous membranes, palms, and soles were spared. The pustules had no surrounding erythema
(
Fig. 3).Multiple 1–2‐mm pustules on the backimageMultiple 1–2‐mm pustules on the proximal, posterior armimageClose‐up of pustules on the backimageA skin biopsy revealed a subcorneal pustule at the follicular orifice with neutrophils and scattered clumps of bacteria consistent with a superficial bacterial folliculitis.The patient was treated with topical clindamycin gel twice a day. He returned 7 days later with a total clearance of his pustules. He had only diffuse, fine scale on the affected areas with no postinflammatory hyperpigmentation.
Ultrastructure of pitted keratolysis
Authors: De Almeida Hiram L. , De Castro Luis A. S. , Rocha Nara E. M. , Abrantes Valter L. 
Published: March 2003

A 20‐year‐old man presented with pitted keratolysis (PK), demonstrating the typical crateriform pits on the hallux ( Fig. 1), ball of the foot, and on the interdigital surface. The involved keratin specimen was obtained by a shaving technique and processed for transmission (TEM) and scanning (SEM) electron microscopy. The patient, who wore only sports shoes, had hyperhidrosis plantaris. He was treated with topical erythromycin with good results. Bacterial cultures from the lesions showed Corynebacterium sp.Crateriform pits on the halluximageTEM demonstrated filamentous coccoid bacteria in the keratin ( Fig. 2), showing transversal septations. Tunnel‐like spaces were built inside the horny layer, where the bacteria showed a hairy surface (

Fig. 3).Bacteria inside the stratum corneum (TEM, × 25,000)imageHairy surface from the causative agent (TEM, × 106,000)imageCrateriform pits ( Fig. 4) and small incipient lesions (

Fig. 5) were easily identified on the plantar surface by SEM. On examination of the floor of these lesions, tunnel openings were found (

Fig. 6) in which bacteria could be observed. With higher magnification, the transversal septation, seen by TEM, was also shown with SEM (

Fig. 7). The normal appearing plantar skin was also examined, showing incipient bacterial colonies with tunnels without keratin loss (

Fig. 8).Pitted keratolysis with two incipient lesions on the right side (SEM, × 77.5)imageHigher magnification of the incipient lesion from the right upper corner of Fig. 4 (SEM, × 310)imageTunnel openings in the floor of the pits (SEM, × 15,500)imageDetails of the bacteria; note the transversal septation (SEM, × 31,000)imageThe causative agent in tunnels in normal appearing skin (SEM, × 4650)image
Survey on the epidemiology of Microsporum canis infections in Crete, Greece over a 5‐year period
Authors: Maraki Sofia , Tselentis Yiannis 
Published: March 2003

Abstract Background
Microsporum canis is a frequent cause of tinea capitis and tinea corporis in Europe and especially in the Mediterranean area. Objective This study was undertaken to examine the epidemiologic features of all cases of M. canis infections recorded in Crete, Greece, during a 5‐year period (1994–1998). Methods The epidemiology of 111 cases of dermatophytoses due to M. canis was analyzed according to the sex, age, origin of the infection, place of residence, body site affected, and seasonal progression. Results
M. canis constituted 24.5% of all dermatophytes isolated during the study period. Women were more frequently affected than men (54%), and infections were most prevalent in patients up to the age of 9 years (46.8%). Cats were identified as the commonest source of the infection (82%). As regarding the place of residence, most of the infected patients came from rural areas (64.9%). The commonest sites of M. canis infection (in decreasing order of frequency) were: the head, the lower extremities, the trunk, and the upper extremities. The greatest number of cases were seen in September and December. Conclusions The findings of the present study indicate that M. canis infections have gradually decreased in recent years in this geographic area. Eradication requires elimination of the natural source of the infection, represented mainly by stray animals.
Anxiety, depression, and nature of acne vulgaris in adolescents
Authors: Aktan Sebnem ,   md, Özmen Erol ,   md, S Berna ,   cedil,   anli,   md
Published: March 2003

Abstract Background The reported prevalence of acne in adolescence is variable; improved treatment may have modified its prevalence and severity; acne has been related to psychiatric morbidity for many years. Methods Two thousand six hundred and fifty‐seven high school students were examined, and adolescents with acne were interviewed about the subject of acne vulgaris. The severity of acne was graded using the Global Acne Grading System (GAGS). The Hospital Anxiety and Depression (HAD) scale was evaluated for one of every two subjects with acne (n = 308) and for the same number of sex‐matched control subjects (n = 308) to determine the prevalence of depression and anxiety. Results Six hundred and fifteen of the subjects (23.1%) were determined to have acne. Acne prevalence in girls and boys was 16.1% and 29.2%, respectively (P < 0.001). Two hundred and twenty‐five (15.8%) of 1424 boys and only 109 (8.8%) of 1233 girls had moderate or severe/very severe acne (P < 0.001), but the GAGS scores in the groups of boys and girls with acne were not significantly different. The acne and control groups showed no significant differences in the HAD anxiety and depression subscale scores. The HAD anxiety subscale scores of girls were significantly higher than those of boys in the acne group. The severity of acne was not correlated with the HAD anxiety or depression subscale scores. Conclusions Acne results in higher anxiety in adolescent girls. Although acne and moderate/severe acne are more common in adolescent boys, the severity of acne was found to be similar in boys and girls with acne. Adolescent girls are more vulnerable than boys to the negative psychological effects of acne.
Oral penicilliosis in a patient with human immunodeficiency virus in northern Thailand
Authors: Kantipong Pacharee , Walsh Douglas S. 
Published: March 2003

A 25‐year‐old Thai woman with human immunodeficiency virus (HIV) infection diagnosed by serology 4 months previously presented to the outpatient clinic with a chief complaint of a sore throat. Three months prior to presentation, she was diagnosed with oral and vaginal candidiasis and bronchitis. The patient was afebrile and other vital signs were normal. Examination of the oral cavity showed patchy erythema and leukoplakia on the buccal mucosa, suggestive of candidiasis. In addition, there were multiple, shiny, translucent papules, 2–4 mm in diameter, especially prominent on the upper palate, suggestive of penicilliosis (Fig. 1). Indeed, a Wright‐stained scraping from a papule revealed numerous inflammatory cells, many containing abundant yeast‐like organisms undergoing binary fission characteristic of penicilliosis (Fig. 2). A slant agar fungal culture of material from an upper palate papule grew Penicillium marneffei, consisting of white, gritty hyphae with underlying deep red coloring as depicted in Fig. 3, as well as Candida albicans. The oral lesions resolved after 2 weeks of treatment with ketoconazole 200 mg twice daily.Oral cavity with shiny, flesh‐colored papules on the upper palate. Arrow shows area from where material for Wright's stain and culture was obtainedimageSmear of papule material from hard palate showing a cluster of intracellular yeast forms (arrow), many undergoing binary fission, consistent with P. marneffei (Wright's stain, × 1000)imageRepresentative slant agar culture of P. marneffei depicting white gritty colonies with underlying red coloringimage
Clinical, histopathologic, and therapeutic aspects of subepidermal autoimmune bullous diseases with IgG on the floor of salt‐split skin
Authors: Barnadas Maria A. , González Ma José , Planagumà Mercè , Romaní Jordi , Curell Román , De Moragas José Ma , Alomar Agustí 
Published: March 2003

Abstract Background  About 12% of patients with subepidermal autoimmune bullous disease and immunoglobulin G (IgG) at the dermal–epidermal junction present diseases other than bullous pemphigoid.Materials and methods  We report the clinical, histopathologic, and therapeutic aspects of eight cases of subepidermal bullous disorder with IgG on the floor of salt‐split skin.Results  A predominant neutrophilic infiltrate was detected in six of the eight patients. In one patient, the inflammatory infiltrate was neutrophilic and eosinophilic in the same proportion. A good response to dapsone alone or combined with prednisone was observed in six patients.Conclusions  The salt‐split skin direct immunofluorescence test is useful for its diagnostic and therapeutic implications.
Levamisole: a safe and economical weapon against pediculosis
Authors: Namazi Mohammad Reza 
Published: March 2003

Twenty‐eight patients with pediculosis capitis, defined as the presence of pruritus, living eggs, and/or lice in the hair, were enrolled in an uncontrolled open pilot study. The subjects were school‐age girls (7–12 years old), apparently free of other diseases, and not treated for pediculosis for 4 weeks prior to this study. Family contacts were not treated for pediculosis. The mothers of the patients, who had given informed consent, were asked not to use any topical pediculocide on the girls during the drug trial. Other than the drug administered in the study, the subjects did not take any oral medicine, including cotrimoxazole and ivermectin, during the trial. Treatment consisted of 3.5 mg/kg once daily oral administration of levamisole for 10 successive days, which was given to the subjects in their school by health personnel. A 10‐day course was chosen because the subjects lived in unhygienic and overcrowded conditions in a poor village where head lice infestation was hyperendemic. Therefore, two treatment courses spaced 10 days apart could not preclude new infestations from other affected persons and fomites and might have led to a false deduction of drug ineffectiveness. Substituting ‘‘N’' for the grade of living nits and ‘‘L’' for adult lice, three forms of response based on the meticulous examination of the entire scalp with the use of a lens with high magnification and a powerful light source were considered: (i) total responsiveness, defined as N2 = 0 and L2 = 0; (ii) partial responsiveness, defined as 0 ≠ N2 < N1 and 0 ≠ L2 < L1; and (iii) complete unresponsiveness, defined as N2 ≥ N1 or L2 ≥ L1. The detection of unhatched nits which were operculated and generally located within one‐quarter of an inch of the scalp was used to indicate the presence of lice infestation and also to judge the clinical response. For those small nits whose opercula were difficult to see with a hand lens, a low power microscopic study was performed to determine whether the nits were unhatched or not.Of the 28 girls enrolled in the study, one patient refused to take the drug after 2 days of treatment. No adverse reactions were noted in any of the 28 subjects. On the 11th day, meticulous hair examination showed that 23 patients had responded to treatment (85%; 95% confidence interval (CI): 66–94%). Of these, 18 showed complete responsiveness (67%; 95% CI: 48–82%). More complete information is given in Table 1. Confidence intervals were calculated using the likelihood method.

The results of the trial of levamisole 3.5 mg/kg once daily for 10 days in the treatment of 27 patients with head lice

Type of response
Number of cases
Percentage
95% confidence interval

Complete responsiveness
18
67%
48–82%

(N2 = 0; L2 = 0)

Partial responsiveness
5
19%
–

(0 ≠ N2 < N1 OR 0 ≠ L2 < L1)

Responsiveness (total + partial)
23
85%
66–94%

Unresponsiveness
4
15%
–

(N2 >= N1; L2 >= L1)

This study suggests that levamisole is effective against pediculosis with a dose of 3.5 mg/kg administered for 10 days.
Lactate dehydrogenase isozymes in and intralesional steroid injection therapy for pseudocyst of the auricle
Authors: Miyamoto Hideaki , Okajima Mitsuya , Takahashi Ikuyo 
Published: March 2003

AbstractBackground  Various treatments for pseudocyst of the auricle have been reported. Recently, several patients have been treated successfully with steroid injections. The lactate dehydrogenase (LDH) levels of cystic fluid have been reported to be high, and the LDH‐4 and LDH‐5 isozymes were found to predominate, although the serum LDH levels and LDH isozyme patterns were normal.Objective  To find a way of preventing auricular pseudocyst recurrences after steroid injection therapy and to examine the relationships between recurrences and the LDH level and isozyme pattern of the cystic fluid.Methods  Steroid injection therapy was given to nine Japanese patients with pseudocyst of the auricle at our clinic between 1994 and 1999. We determined the LDH level and isozyme pattern of the cystic fluid and sera of seven patients.Results  All nine patients in this series were treated successfully with steroid injections, although three suffered recurrences. Although the serum LDH levels of seven patients were almost normal, their cystic fluid LDH levels were very high. LDH‐4 and LDH‐5 predominated in the cystic fluid of all seven, although their serum LDH isozyme patterns were virtually normal.Conclusions  Auricular pseudocyst recurrences show no relationship with either the LDH levels or isozyme pattern. An undiluted solution of steroid fluid should be used in order to prevent recurrences.