Showing papers in "Dermatology in 1999"
TL;DR: From the exceedingly high rate of smokers among patients with this condition, it is concluded that cigarette smoking is a major triggering factor of hidradenitis suppurativa.
Abstract: Background: Hidradenitis suppurativa is a chronic inflammatory skin disease involving the axillary, inguinal and anogenital regions and sometimes, in addition, the submammary or sac
237 citations
TL;DR: The feasibility of using color Doppler optical coherence tomography (OCT) and image processing techniques to locate, measure and reconstruct cutaneous blood vessels in rat and hamster skin shows that the technique is a potential tool for improving laser treatment of vascular disorders.
Abstract: Purpose: Current laser treatment for vascular disorders such as port wine stains can have incomplete or unacceptable results. A customized treatment strategy based on knowledge of t
147 citations
TL;DR: Many of the criteria commonly used for the differential diagnosis of SCC and KA are not reliable and should be considered and treated as SCC, since a clear-cut distinction is not possible even with the aid of the most relevant criteria.
Abstract: Background: Squamous cell carcinoma (SCC) and keratoacanthoma (KA) are sometimes difficult to distinguish by histopathological examination, since cytological features are similar in
130 citations
TL;DR: Although laser therapy was not applied as a monotherapy, the present observation suggests that it might constitute a useful side-effect-free alternative treatment modality for the induction of wound healing of neuropathic ulcers in diabetic patients.
Abstract: Objective: To evaluate the efficacy of low-intensity laser irradiation for the induction of wound healing of a diabetic neuropathic foot ulcer Case: We report a
100 citations
TL;DR: Antibacterial therapy with gentian violet not only reduces S. aureus dramatically, but also reduces the severity of the eczema, and seems to be secondary to improvement of the skin condition.
Abstract: Background: In atopic eczema (AE), skin colonization with Staphylococcus aureus plays a possible role in the pathophysiology of the disease. Methods: Thirty-eight
95 citations
TL;DR: The obtained results suggest that Belanyx lotion can be used in this indication since it has shown a favourable efficacy-safety ratio and addition of 1% 5-fluorouracil to the nail permeation enhancer BelanyX does not increase the efficacy of the active agent in psoriatic nail dystrophy of this study population.
Abstract: Background: Topically applied nail therapeutics need to permeate the nail plate to reach the nail bed or nail matrix and exert their potential beneficial effect at these locations t
90 citations
TL;DR: The natural retinoids ROL and RAL do have a good tolerance profile, in contrast with the irritating potential of RA, and under maximized conditions, an equally low irritation potential for ROLand RAL and a more pronounced irritant effect with RA could be demonstrated clinically.
Abstract: Background: Topical retinoic acid (RA) causes irritation of the skin. To prevent this side effect, natural precursors of RA have been proposed. The aim of the present study was to c
85 citations
TL;DR: Partial to near – total repigmentation of a vitiligo patch can be achieved by PG, andMelanocyte transplantation by punch grafting can restore the normal pigmentation.
Abstract: Background: Stable and refractory vitiligo may be unresponsive to medical therapy. Melanocyte transplantation by punch grafting (PG) can restore the normal pigmentation. Ob
82 citations
TL;DR: UVR-induced skin damage is a rapid event, and antioxidants possibly prevent such damage only when present in relevant concentration at the site of action beginning and during oxidative stress.
Abstract: Background: Photoprotective effects of topically applied antioxidants when applied before ultraviolet radiation (UVR) exposure are well known. Their protective effect when applied a
79 citations
TL;DR: Modern cryosurgery was born in the 1960s after liquidnitrogen became available, and closed-circuit devices work-ing with liquid nitrogen, freon gas and nitrogen protoxide have been developed by the American neurosurgeons I.S.Cooper and A.A. Lee and their Italian colleagues.
Abstract: Skin diseasesIntroductionCryosurgery is the well-aimed and controlled destructionof diseased tissue by application of cold (table 1). It hasbeen shown to be effective and efficient in various skindiseases, provides high cure rates and good cosmetic resultswith a few contra-indications and low incidence of compli-cations [1].History of CryosurgeryThe first physician who used freezing to treat a dermato-logical disease was C. Gerhardt, a German dermatologistfrom Jena [2]. In 1885, he published a paper on the treat-ment of cutaneous tuberculosis with cold. Gerhardt had builta system, in which the lesions were covered with ice blad-ders for 3 h twice a day. Four patients considerably im-proved after a 2- to 4-week treatment. In 1899, A.C. White,an American dermatologist from New York, used for thefirst time liquefied air to treat various skin disorders, such asverrucae vulgares, naevi, precancerous lesions and tumours.In the year 1905, M. Juliusberg, a dermatologist fromBerlin, introduced the term ‘cryotherapy’ for the treatmentof skin lesions with cold. He applied the first cryospray, asmall balloon filled with carbon dioxide released in spurts.Modern cryosurgery was born in the 1960s after liquidnitrogen became available, and closed-circuit devices work-ing with liquid nitrogen, freon gas and nitrogen protoxidehave been developed by the American neurosurgeons I.S.Cooper and A.S. Lee and their Italian colleagues V.A.Fasano, G. Broggi, T. de Nunno and P. Baggiore. Nowa-days, numerous sophisticated devices have been developedand commercialized, not only to preserve and deliver cryo-gens, but also to monitor temperatures in and underneaththe treated lesions, thus allowing a controlled and reliablecryosurgery of the diseased skin.CryobiologyThe biological changes that occur during and after cryo-surgery have been studied in vitro and in vivo and arecaused by reduction of tissue temperature and consequentfreezing [3–6]. Tissue injury is induced by cell freezing andby the vascular stasis that develops in the tissue after thaw-ing. The cryoreaction is, therefore, characterized by the
76 citations
TL;DR: The state-of-the art therapy of cutaneous T cell lymphoma (CTCL) is reviewed and Retinoids may be of value for early and moderately advanced CTCL particularly in combination with other agents such as IFN-α and PUVA.
Abstract: The state-of-the art therapy of cutaneous T cell lymphoma (CTCL) is reviewed. Commonly used treatments for early-stage (patch/plaque) mycosis fungoides (MF) include topical corticosteroids, mechloreth
TL;DR: A further case of lichen planus (LP) occurring after vaccination against hepatitis B virus (HBV) is reported, indicating that postvaccine LP is a rare event.
Abstract: Dr. Alfredo Rebora Department of Dermatology, University of Genoa Viale Benedetto XV I–16132 Genova (Italy) Tel. +39 10 353 8414, Fax +39 10 353 8401 Ferrando et al. [1] in this tissue of Dermatology report a further case of lichen planus (LP) occurring after vaccination against hepatitis B virus (HBV). We are aware of 18 cases [2–11], including 2 observed by us and still unpublished (table 1). What could have been a coincidence in 1990 [2], should be now recognized as a genuine side effect of the HBV vaccine [12]. These observations deserve some comment. (1) Because of the diffusion of HBV vaccination, 18 cases in 7 years indicate that postvaccine LP is a rare event. Many cases may certainly go undetected or be dumped as ‘skin rashes’, but their theoretical importance may be underrated as well. (2) All cases have been described in Italy and in France. It is surprising that, given the number of HBV vaccinations worldwide, similar cases have not been reported elsewhere, particularly in the USA, where a good proportion of people are of Mediterranean stock. (3) Although a case-control study is needed to definitely exclude coincidence, we may assume that it is unlikely. The observation of 3 cases in children [9], in whom LP is extremely rare, the exacerbation after the 2nd dose [7] or after the booster dose in one of our unpublished cases, and the severity of the lesions in a patient previously infected by HBV [11], all support the causal role of vaccination. (4) A chronic graft-versus-host(GVHR)-like autoimmune reaction has been suggested as a pathogenetic mechanism. Except for Lefort et al. [8] and Ferrando et al. [1] cases, in which LP developed as early as 7 and 15 days respectively after the 1st dose, latency is in keeping with this interpretation. In chronic GVHR, the lichenoid eruption may develop up to months or even years after bone marrow transplantation. (5) Whenever studied, seroconversion followed vaccination in all cases except in Ferrando et al. [1]. In the original case [2], the HBsAb titer was low (16 IU/l) and even disappeared 1 year later. In the other cases, the titers ranged between 82 [8] and 582 IU/l [7]. In 2 cases [2 and one of our cases], also HBcAb was present, an antibody that cannot be induced by the vaccines. Because of the negative prevaccination serology, this was probably a false-positive finding. The absence of HBeAb makes very unlikely that the patient got infected in the interval between doses. An old infection was suggested when the eruption started after the 1st dose [7]. This would be the case only if the patient, infected before vaccination, did not seroconvert. (6) The vaccines are disparate. In 2 cases, the vaccines were obtained by inactivation of a plasma-derived HBsAg, while in the other cases they were recombinant proteins. All these vaccines share only protein S as a common component. HBsAg is a mosaic of epitopes (S, pre-S1 and pre-S2) each of which is immunogenic. While the plasma-derived vaccines contain all the epitopes, recombinant ones do not. In Pusel’s [4] and Aubin’s [5] cases, the vaccine did not contain the pre-S1 epitope. Recombivax [3] did not contain the pre-S2 epitope and Engerix B [7, 9, 10 and one of our upublished cases] neither pre-S1 nor pre-S2, but only S. LP, therefore, may well develop as an immune reaction to keratinocytes expressing S epitope. Likewise, in patients with chronic postviral hepatitis, LP would be a cytotoxic reaction to keratinocytes expressing HBs and not epitopes shared by the hepatocytes damaged by the virus as suggested [13]. More simply, the vaccine may stimulate the immune system nonspecifically triggering LP eruption as it does with other immune-related disorders, including lupus erythematosus [14]. However, we are unaware of lichenoid eruption
TL;DR: Clinicians should recognize the clinical picture of these adverse nail reactions because docetaxel is used for several neoplastic disorders and there are no efficacious preventive measures to avoid its development.
Abstract: Docetaxel is a new taxoid antineoplastic drug widely used for advanced breast cancer. Skin and nail toxicity are one of the more frequent nonhematologic adverse reactions. Besides dark pigmentations and Beau's lines, subungual hemorrhage, orange discoloration, acute painful paronychia, onycholysis, subungual hyperkeratosis and transverse loss of the nail plate are described. The type of nail alteration is related with the number of cycles administered and there are no efficacious preventive measures to avoid its development. Clinicians should recognize the clinical picture of these adverse nail reactions because docetaxel is used for several neoplastic disorders.
TL;DR: No statistically significant differences were found in the disease course between early- and adult-onset MF, and the predominant phenotype was CD3+ CD4+CD7–CD8–.
Abstract: Background: Mycosis fungoides (MF) is rare in young patients. Its clinical behavior is still uncertain, as some reports have suggested that it has a more aggressive course than does the adult-onset type. Aim: To ascertain if early-onset MF represents a heterogeneous group of cutaneous T cell lymphomas. Materials and Methods: Clinical, immunohistopathological and follow-up data of early-onset (Results: The majority of the 49 early-onset MF patients had patch-plaque stage disease at diagnosis. Ten had hypopigmented lesions. The predominant phenotype was CD3+ CD4+CD7–CD8–. Seven patients had a stage progression, 6 with extracutaneous involvement. Five- and 10-year survival rates were 93 and 74%, respectively. Conclusions: No statistically significant differences were found in the disease course between early- and adult-onset MF.
TL;DR: It is demonstrated that salicylic acid is well absorbed by healthy skin and significant differences in the doses absorbed were detected between the two formulations a and b with different vehicles.
Abstract: Objective: To determine the amount of drug which is absorbed during 1 day following topical application of three different preparations containing salicylic acid. Methods:&
TL;DR: Nitrite, nitrate and nitrite + nitrate levels in the active period of the disease were found to be decreased compared to the inactive period and the control group, and it was concluded that decreased NO production in patients with Behçet’s disease may have critical biological activities relevant to pathologic events in theactive period.
Abstract: Background: Behcet’s disease is a chronic multisystemic disorder which is characterized by a relapsing systemic inflammatory process. One of the features of Behcet’s disease is endo
TL;DR: The result indicates a beneficial effect of combining calcipotriol and phototherapy, and the addition of UVB to calcipOTriol did not alter the tolerability or safety of topically applied calcipolriol.
Abstract: Background: Calcipotrial has a well-documented effect in the treatment of psoriasis. Objective: To confirm the beneficial effect of the combination of calcipotrio
TL;DR: In 13 patients with Behçet’s disease, the number and size of oral and genital ulcers diminished significantly and various clinical manifestations regressed after the eradication of HP, suggesting HP may be involved in the pathogenesis of BD.
Abstract: Background: Recent investigation of the etiology of Behcet’s disease (BD) has focused on heat shock proteins (HSP) which belong to the HSP 60 family. Both the gastric pathogen Helic
TL;DR: The genetics of PXE as well as the importance of early diagnosis and genetic counseling are addressed, and management of the disease and current areas of research are discussed.
Abstract: Pseudoxanthoma elasticum (PXE) is an inherited disorder of elastic tissue with many systemic manifestations. The disease varies widely in its degree of expression and inheritance patterns and is believed to be considerably underdiagnosed due to lack of familiarity with the condition among physicians. The purpose of this article was to provide an update on important topics in PXE. Common presentations of the disease as well as the histopathology are discussed. The genetics of PXE as well as the importance of early diagnosis and genetic counseling are addressed. Special areas of concern, such as PXE in childhood, are reviewed. Finally, the article concludes with management of the disease and current areas of research.
TL;DR: The major clinical features of juvenile-onset and adult-ONSet disease in Germany are comparable, but in juvenile-onsonet disease, the course is delayed and patients experience less severe complications.
Abstract: Background and Objective: Adamantiades-Behcet disease is a rare entity at a juvenile age We aimed to enlighten epidemiological and clinical characteristics of juvenile-onset disease in Germany Methods: Data from the German Registry were used to compare clinical and epidemiological features of patients with juvenile-onset (≤16 years) and adult-onset (>16 years) disease diagnosed according to the criteria of the International Study Group Results: Twenty-eight (17%) of 168 patients of the German Registry exhibited the onset of the disease and 8 (5%) of them the complete symptom complex at a juvenile age Juvenile-onset disease was characterized by an increase in familial cases (25 vs 8% in patients with adult-onset; p = 0047) The frequency of diagnostic signs was similar between the two study groups In juvenile-onset disease, delayed development of the complete symptom complex (median value 35 months vs 12 months after onset; p = 0014) and lower prevalence of severe complications (9 vs 29%; p = 0042) were detected Conclusions: The major clinical features of juvenile-onset and adult-onset disease in Germany are comparable, but in juvenile-onset disease, the course is delayed and patients experience less severe complications In addition, there is a higher rate of familial occurrence of the disease in patients with juvenile-onset
TL;DR: Patients do not only illustrate the different expressions of JHF but also show some overlap with ISH, suggesting a common cause for both disorders, which are sometimes difficult to separate.
Abstract: Background: Systemic hyalinoses are genetic generalized fibromatoses characterized by an accumulation of hyalin in the dermis. Two distinctive syndromes are recognized in the litera
TL;DR: Short-time ECP is an effective and safe adjuvant treatment for patients with drug-resistant autoimmune bullous diseases and can induce remission and allows dose tapering of the immunosuppressive drugs.
Abstract: Background: Bullous pemphigoid (BP) and pemphigus vulgaris (PV) are potentially severe diseases. In drug-resistant PV and pemphigus foliaceus, long-term adjuvant treatment with extr
TL;DR: MDD, TCD, closed comedonal acne and hyperandrogenism that have been adequately treated prior to isotretinoin treatment had no prognostic value for relapse.
Abstract: Background: The efficacy of oral isotretinoin in acne has been established, though the role of the mean daily dose (MDD) is still unclear. Objective: To determine
TL;DR: It is wondered whether IVIg could reproduce immunological mechanisms involved in the 3 types of systemic contact dermatitis (pompholyx, baboon syndrome and maculopapular rash), including the epidermal expression of P-selectin.
Abstract: Following the second series of intravenous human immunoglobulins (IVIg; 0.4 g/kg) prescribed to treat a sensorimotor polyneuritis, a 28-year-old woman developed pompholyx that recurred after each of t
TL;DR: The coincidence of plaque-type psoriasis and a pustular eruption as described previously in impetigo herpetiformis supports the view that this dermatosis of pregnancy is a variant of generalized pustules-type Psoriasis.
Abstract: A 17-year-old woman had a sudden eruption of pustules in her intertriginous areas as well as of erythematosquamous plaques on the scalp, elbows, palms and soles in the third trimester of her first pregnancy. Histopathological evaluation of a biopsy revealed typical changes of pustular psoriasis with parakeratosis and abscesses of neutrophils (Kogoj's spongiform pustules). The diagnosis of pustular psoriasis was established by the typical clinical and histopathological findings. Laboratory parameters showed a highly elevated blood sedimentation rate, hypoferric anemia and decreased albumin levels. Serum concentrations of parathormone and its metabolites were normal. After systemic treatment with glucocorticosteroids and antibiotics, the lesions improved but did not clear. After delivery of a healthy boy, therapy was switched to retinoid photochemotherapy with isotretinoin and PUVA that resulted in rapid and complete clearing of the eruption. The coincidence of plaque-type psoriasis and a pustular eruption as described previously in impetigo herpetiformis supports the view that this dermatosis of pregnancy is a variant of generalized pustular psoriasis.
TL;DR: A 48-year-old patient under immunosuppressive therapy for renal transplantation had contagious ecthyma which relapsed after excision and stable healing was obtained by cryotherapy.
Abstract: A 48-year-old patient under immunosuppressive therapy for renal transplantation had contagious ecthyma which relapsed after excision. Stable healing was obtained by cryotherapy.
TL;DR: This is the first report on an elevated incidence of cutaneous malignant fibrous histiocytoma and of atypical fibroxanthoma in renal transplant recipients and future cohort studies on malignancies in organ allograft recipients should aim at defining this risk more exactly.
Abstract: Background: Allograft recipients are at increased risk for skin cancer. The incidence of cutaneous squamous cell carcinoma is 50–250 times higher than in the age-matched control pop
TL;DR: 9-cis-RA is a valuable drug when given at low doses to patients with chronic hand eczema in a pilot study in an exploratory open-label study.
Abstract: Background: 9- cis -Retinoic acid (9- cis -RA) has a particular pattern of binding and activating retinoid receptors. Treatment of chronic hand ecz
TL;DR: A 12-year-old boy who presented with an 8-month history of erythematous mucinous plaques on the scalp, accompanied by cervical lymphadenopathy, and a biopsy showed follicular mucinosis and epidermotropism of the lymphocytic infiltrate is reported.
Abstract: Mycosis fungoides is a cutaneous T-cell lymphoma (CTCL) usually observed in mid to late adulthood. It occurs only rarely during childhood. Follicular mucinosis is a chronic dermatosis involving the sebaceous glands and outer root sheaths. It is normally differentiated into a juvenile benign form and an adult form possibly associated with mycosis fungoides. We report a 12-year-old boy who presented with an 8-month history of erythematous mucinous plaques on the scalp. Three months later, he developed erythematous patches and plaques on his whole body, accompanied by cervical lymphadenopathy. A biopsy showed follicular mucinosis and epidermotropism of the lymphocytic infiltrate. Immunophenotyping and a PCR clonality test were consistent with CTCL. The patient received PUVA treatment and local steroids, resulting in partial remission. Mycosis fungoides should be considered in the differential diagnosis of chronic, scaling dermatoses in childhood. Moreover, follicular mucinosis in childhood can be associated with mycosis fungoides.
TL;DR: The first report of multiple pilomatrixomas in Turner’s syndrome is reported, including atypical occurrences on the chest and the posterior aspect of the leg.
Abstract: Multiple and familial cases of pilomatrixomas have been reported in myotonic dystrophy. We report 2 cases of pilomatrixoma in Turner's syndrome. Between 5 and 19 years of age, 1 patient developed 6 pilomatrixomas including atypical occurrences on the chest and the posterior aspect of the leg. This is the first report of multiple pilomatrixomas in Turner's syndrome.