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Biomedical subjects

A Alomar

Publications and source records attributed to A Alomar.

At least 55 records · Page 3Linked to original sources
PubMed2001

Sunscreen and risk of osteoporosis in the elderly: a two-year follow-up.

BACKGROUND: It has been suggested that the use of sunscreens to prevent skin cancer may put the population at risk of vitamin D deficiency, which in turn may lead to secondary hyperparathyroidism, loss of cortical bone and, ultimately, osteoporotic fractures. OBJECTIVE: To investigate whether sunscreen SPF15 may lead to loss of bone mass. METHODS: We followed 10 sunscreen users and 18 controls over 2 years, including two summers, two winters and a basal period (winter). Bone mass was evaluated each season with dual x-ray absorptiometry. RESULTS: During follow-up, mild fluctuations in bone mass could be seen at Ward's site in both groups, without a definitive pattern. At the final visit, no significant loss of bone mass was observed in sunscreen users or in the control group. We did not observe any significant differences between groups throughout the study. CONCLUSION: Although the study samples in this work are small, and a slight variation in bone mass may not be detected, in a clinical setting, sunscreen SPF15 protection does not seem to increase the risk of osteoporosis.

Aged↗
PubMed2000

HIV-1 protease inhibitor-associated partial lipodystrophy: clinicopathologic review of 14 cases.

BACKGROUND: A novel type of acquired partial lipodystrophy resulting from chronic treatment with HIV-1 protease inhibitor drugs has recently been described. OBJECTIVE: We studied the clinical and histopathologic features of a series of patients with HIV-1 protease inhibitor-associated lipodystrophy to evaluate the frequency of associated abnormalities. METHODS: The study group consisted of 14 consecutive HIV-infected patients receiving treatment with HIV-1 protease inhibitors, who experienced partial lipodystrophy. Clinical (including anthropometric data) and histopathologic findings, as well as biochemical and virologic data, were evaluated. RESULTS: A significant loss of fat in the face and extremities was associated with fat deposition on the abdomen, breast, and dorsocervical fat pad. Central obesity was frequently present. Histopathologic features disclosed a peculiar type of involutional lipodystrophy. Hypertriglyceridemia was detected in 78.5% of patients. Low serum levels of cholesterol-high-density lipoprotein and high cholesterol-very-low-density lipoprotein were noted. Hyperglycemia, hypercholesterolemia, or hyperinsulinemia were occasionally detected. CONCLUSION: HIV-1 protease inhibitor-associated lipodystrophy represents a new entity with peculiar clinical and histopathologic features. Metabolic associated abnormalities may imply a risk of future atherogenic complications.

Adult↗
PubMed2000

Generalized pruritic eruption with suprabasal acantholysis preceeding the development of bullous pemphigoid.

We report a patient who presented with a papular pruritic eruption of a 3-month duration that histologically showed suprabasal acantholysis accompanied of an eosinophilic inflammatory infiltrate that was consistent with the diagnosis of Grover's disease. Later, erythematous plaques and vesicles appeared which showed a histopathological pattern of eosinophilic spongiosis. The direct immunofluorescence (DIF) study showed lineal IgG and C'3 at the dermal epidermal junction which was consistent with the diagnosis of bullous pemphigoid. No anti-intercellular deposits of immunoglobulin G (IgG) or C'3 were observed. We consider that suprabasal acantholysis may represent the early phase of bullous pemphigoid.

Acantholysis↗
PubMed2000

Cutaneous infections due to nontuberculous mycobacteria: histopathological review of 28 cases. Comparative study between lesions observed in immunosuppressed patients and normal hosts.

To evaluate the histopathological features observed in patients with cutaneous infections due to nontuberculous mycobacteria (NTM) and to compare the histopathological patterns observed in immunosuppressed patients and normal hosts. Twenty-eight biopsy specimens corresponding to 27 patients with cutaneous infections due to NTM were reviewed. Eighteen biopsies corresponded to normal hosts (14 Mycobacterium marinum, 2 Mycobacterium chelonae, 1 Mycobacterium terrae and 1 Mycobacterium gordonae) and 10 biopsy specimens were obtained from 9 immunosuppressed patients (3 Mycobacterium chelonae, one of which had two biopsies, 1 Mycobacterium abscessus, 2 Mycobacterium kansasii, 1 Mycobacterium marinum, 1 Mycobacterium avium complex and 1 Mycobacterium simiae). A panel of histopathological features was evaluated by two independent observers in each biopsy specimen. Epidermal changes (acanthosis, pseudoepitheliomatous hyperplasia, exocytosis) were mainly observed in M. marinum infections. In immunosuppressed patients the infiltrate tended to be deeper, involving the subcutaneous tissue (100%) with a more diffuse distribution and constant abscess formation. A marked granulomatous inflammatory reaction was observed in 83% of immunocompetent and in 60% of immunosuppressed patients. In immunosuppressed patients a relationship between the chronic evolution of the disease and granuloma formation was demonstrated. A diffuse infiltrate of histiocytes with occasionally foamy appearance was noted in three biopsy specimens from three patients with AIDS. Acute and chronic panniculitis was detected in 8 biopsy specimens. In one biopsy (M. chelonae) an acute suppurative folliculitis was observed. Different histopathological patterns can be noted in biopsy specimens from cutaneous nontuberculous mycobacterial infections. The evolution of the disease and the immunologic status of the host may explain this spectrum of morphological changes. Tuberculoid, palisading and sarcoid-like granulomas, a diffuse infiltrate of histiocytic foamy cells, acute and chronic panniculitis, non-specific chronic inflammation, cutaneous abscesses, suppurative granulomas and necrotizing folliculitis can be detected. Suppurative granulomas are the most characteristic feature in skin biopsy specimens from cutaneous NTM infections. Some histopathological patterns seem more prevalent in immunosuppressed patients.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Subcutaneous sarcoidosis associated with vitiligo, pernicious anaemia and autoimmune thyroiditis.

We report a patient with pernicious anaemia, primary autoimmune hypothyroidism and vitiligo, who presented with subcutaneous nodules. Histopathology of the nodules revealed noncaseating granulomas, consistent with a diagnosis of sarcoidosis. Mild pulmonary sarcoid was also detected. Although an association between sarcoidosis and other autoimmune diseases is well-recognized, the presence of the particular autoimmune diseases in our patient and the involvement of subcutaneous fat in the sarcoidal inflammation, appears to represent a most unusual clinicopathological combination.

Adult↗
PubMed2000

Graves' disease presenting as localized myxoedematous infiltration in a smallpox vaccination scar.

We describe a 54-year-old woman with diffuse myxoedematous infiltration at the site of a smallpox vaccination scar as the presenting symptom of Graves' disease. Associated features included acute ocular symptoms (vascular congestion of the sclera, epiphora and blurred vision) and transient erythema on both shins. However, there were no signs of pretibial myxoedema. A number of neoplastic, inflammatory and systemic diseases may localize to scar tissue in skin, including at smallpox vaccination sites, but this case demonstrates the unusual occurrence of myxoedematous infiltration at such a site and illustrates a most atypical cutaneous presentation of Graves'disease.

Cicatrix↗
PubMed2000

Oral ulcerations as the first sign of a foramen magnum meningioma.

We report the case of a patient with oral ulcerations that were likely traumatic in origin caused by biting of the tongue. Physical examination showed only deviation, fasciculations, and hemiatrophy of the right side of the tongue. Neurologic examination disclosed an isolated XII nerve palsy. A magnetic resonance image showed a lesion in the posterior fossa displacing the brain stem at a bulbar level. This was consistent with the diagnosis of a meningioma, later confirmed by the histopathologic study. It is very unusual that a meningioma produces a selective involvement of the XII nerve. Early diagnosis of a foramen magnum meningioma is important, both to improve prognosis and to avoid neurologic sequelae.

Aged↗
PubMed1999

Grover's disease in patients with chronic renal failure receiving hemodialysis: clinicopathologic review of 4 cases.

In 4 patients undergoing hemodialysis for chronic renal failure, a transient or persistent, papular and keratotic eruption developed on the trunk and arms. Histologic examination disclosed focal acantholysis with dyskeratosis. The lesions were clinically and histologically indistinguishable from those of Grover's disease. A possible association with Grover's disease and chronic renal failure and/or hemodialysis is postulated. Possible implicated pathogenic mechanisms are discussed. We suggest that Grover's disease should be included in the differential diagnosis of cutaneous eruptions in patients with chronic renal failure.

Adult↗
PubMed1999

Repeat direct immunofluorescence (DIF) test, using, 1 M NaCl treated skin, in the subepidermal autoimmune bullous diseases that contain IgG at the dermal epidermal junction.

Knowledge of autoimmune bullous diseases has greatly increased with the recognition of new entities, and the use of the direct immunofluorescence (DIF) using 1 molar per liter of sodium chloride (1 M NaCl) treated skin has been proposed. To estimate the frequency with which the different DIF patterns are present, we performed a systematic study of the skin or oral mucosa samples in which linear deposits of IgG at the basement membrane zone were detected by routine DIF in the last 6 years. The DIF tests were done on 56 samples before and after splitting the epidermis from the dermis with 1M NaCl. In 40 biopsies (72%) IgG was found on either the epidermal side or on both sides after 1M NaCl split. These cases corresponded to bullous pemphigoid (n=33), herpes gestationis (n=5) and cicatricial pemphigoid (n=2). In 6 cases (10.7%), IgG deposits were observed only on the floor, five corresponding to bullous pemphigoid and one to bullous pemphigoid-like eruption induced by amoxicillin. Repeat direct immunofluorescence using 1M NaCl split skin indicates that at least 12% of patients who were initially diagnosed as bullous pemphigoid, may in fact suffer a different entity, requiring other techniques to achieve the right diagnosis. This test can be a useful routine screening for autoimmune bullous diseases.

Dermis↗
PubMed1999

Differential expression of c-Met in Kaposi's sarcoma according to progression stage and HIV infection status.

Several cytokines, growth factors and the HIV transactivator Tat have been shown to be involved in the pathogenesis of Kaposi's sarcoma (KS). Hepatocyte growth factor/scatter factor (HGF) is an angiogenic cytokine that stimulates proliferation of spindle cells cultured from human KS lesions. The receptor for HGF, the c-Met protein, is expressed by endothelial cells, dermal dendrocytes and KS tumor cells both in vitro and in vivo. KS cells synthesize and secrete HGF and express the hepatocyte growth factor receptor (c-Met), thus providing an autocrine loop for tumor proliferation and neovascularization which can be enhanced by proinflammatory cytokines. We studied the immunohistochemical expression of c-Met in 40 cases of classical Kaposi's sarcoma (C-KS) and AIDS-associated cutaneous Kaposi's sarcoma (AIDS-KS), including 22 plaque stage lesions (12 AIDS-KS cases) and 18 tumor stage lesions (7 AIDS-KS cases). Statistically significant differences in the average intensity of immunohistochemical staining according to the type of lesions progression stages) and the serologic status of the patients were identified. The staining intensity of c-Met was stronger in tumors than in plaques. When only plaques were taken into consideration, the mean staining score was nearly twice as high in C-KS as in AIDS-KS.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Cutaneous granulomatous lesions in common variable immunodeficiency: complete resolution after intravenous immunoglobulins.

A 64-year-old man with common variable immunodeficiency developed a persistent papulonodular ulcerative eruption on the right leg. Histopathological examination disclosed a chronic inflammatory infiltrate with central necrosis and palisading granuloma. Repeated microbiological (bacteriological, mycological and mycobacteriological) studies failed to isolate any microorganism. After treatment with intravenous immunoglobulins, a progressive resolution of the skin lesions was observed with a complete clearing after 10 months. Clinicopathological features and therapeutic approaches of sterile granulomatous lesions associated with primary immunodeficiencies are reviewed.

Common Variable Immunodeficiency↗
PubMed1999

Benign lymphoepithelial tumor of the skin ("cutaneous lymphadenoma").

"Benign lymphoepithelial tumor of the skin" or "cutaneous lymphadenoma" is a distinctive benign adnexal tumor presenting a characteristic combination of lobules of epithelial basaloid cells with a peculiar histopathological pattern and a dense intraepithelial T-cell lymphoid and histiocytic population. We report an additional example of this peculiar neoplasm. In addition to the characteristic histopathological features, focal areas showing unequivocal follicular differentiation were observed at the periphery of the tumor. In agreement with other authors we consider that this neoplasm should be included within the spectrum of neoplasms of pilosebaceous origin. Nevertheless, we consider that the original and simple concept of "benign lymphoepithelial tumor of the skin" seems more suitable and illustrative than the more widely used term of "cutaneous lymphadenoma" to define this rare benign adnexal neoplasm.

Adenolymphoma↗
PubMed1998

Persistent supravenous erythematous eruption: a rare local complication of intravenous 5-fluorouracil therapy.

We describe a 47-year-old man who developed a linear serpentine erythematous eruption, overlying the superficial veins on both arms, after treatment with intravenous 5-fluorouracil. No evidence of superficial phlebitis or extravasation were observed. Histologically, a prominent vacuolar alteration of basal cells, necrotic keratinocytes, pigment incontinence, and a perivascular lymphocytic infiltrate in the upper dermis were observed. In a review of the literature we encountered only 5 reports of a similar clinicopathologic picture. The term "persistent supravenous erythematous eruption" (PSEE) seems suitable to describe this rare and peculiar cutaneous eruption that develops after intravenous cytotoxic drug treatment.

Antimetabolites, Antineoplastic↗
PubMed1998

Bullous pemphigoid associated with acute glomerulonephritis.

We report an 82-year-old man who presented with bullous pemphigoid and who later developed an acute glomerulonephritis with the histopathological and immunofluorescence pattern of a postinfectious glomerulonephritis. Antibodies directed against 230 and 180 kDa bullous pemphigoid antigens were detected in the patient's serum by means of the immunoprecipitation technique. Staphylococcus aureus and methicillin-resistant S. aureus were isolated from the patient's skin. We consider that in this particular patient the cutaneous infection played a part in the development of the kidney complication.

Acute Disease↗