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A Blauvelt

Publications and source records attributed to A Blauvelt.

53 records · Page 3Linked to original sources
PubMed1993

Widespread primary cutaneous infection with Mycobacterium fortuitum.

BACKGROUND: Cutaneous infection with Mycobacterium fortuitum, a ubiquitous rapid growing atypical mycobacterium, most often occurs as a postsurgical wound complication or at the site of a penetrating injury to the skin. Rarely, disseminated infection with cutaneous involvement can occur in immunocompromised patients. CASE REPORT: A 47-year-old black woman presented with a 10-year history of numerous draining abscesses and tender nodules on the back and buttocks unresponsive to oral and intravenous antibiotics. Biopsy showed a granulomatous and suppurative dermatitis and panniculitis and special stains did not reveal organisms. M. fortuitum was cultured from involved skin on two separate occasions. The patient improved with a 2-week course of intravenous amikacin and cefoxitin combined with oral probenecid followed by a course of doxycycline and ciprofloxacin. CONCLUSIONS: Widespread primary cutaneous infection with M. fortuitum may occur in an immunocompetent patient. Chronic draining skin abscesses unresponsive to routine antibiotics may represent infection with an atypical mycobacterium; tissue cultures of affected skin should be performed to rule out this possibility. Therapy should be directed by culture sensitivity results.

Female↗
PubMed1993

Human papillomavirus DNA in the dermis of condyloma acuminatum.

Condyloma acuminatum (CA) has high recurrence rates after local treatments. Why this lesion is difficult to eradicate is unclear. One possible explanation for recurrence after superficial destructive therapy is the presence of residual human papillomavirus (HPV) in the superficial dermis beneath the treated epidermis. Thirteen samples of CA were excised from 13 patients. Thirteen samples of basal cell carcinoma (BCC) were studied for purposes of control. Epidermis was separated from dermis by treatment with sodium bromide. DNA was extracted from both tissues and used sodium bromide solution and amplified for the presence of HPV DNA using the polymerase chain reaction. HPV DNA was detected in the epidermis of 11 samples of CA. HPV type 6 was seen in 7 specimens; HPV type 11, in 4. HPV DNA was found in the dermis of 3 specimens of CA; type 6 in 2 and type 11 in 1. Two samples were excluded because of contamination of the sodium bromide solution by HPV. HPV DNA was not detected in tissue samples from BCC. The presence of HPV DNA in the dermis of some condylomata may explain recurrence in sporadic cases.

Base Sequence↗
PubMed1993

Identification of Mycobacterium tuberculosis DNA in five different types of cutaneous lesions by the polymerase chain reaction.

BACKGROUND AND DESIGN: A spectrum of skin lesions are believed to be secondary to the presence of Mycobacterium tuberculosis. Demonstration of M tuberculosis directly or in culture in some of these eruptions can be difficult. We used the polymerase chain reaction and a primer/probe set specifically for M tuberculosis complex DNA to evaluate five types of skin lesions clinically considered to represent infection by, or reaction to, M tuberculosis. OBSERVATIONS: Mycobacterium tuberculosis DNA was demonstrated in paraffin-embedded sections of these five cases, representing a variety of clinical and histologic patterns. In two cases, M tuberculosis could not be demonstrated by routine cultural methods. CONCLUSION: DNA diagnostic methods such as the polymerase chain reaction can be used to rapidly identify cutaneous lesions produced by M tuberculosis.

Adult↗
PubMed1992

Basal cell carcinoma of the scrotum. Report of three cases and review of the literature.

BACKGROUND: Although basal cell carcinoma (BCC) is the most common human malignancy, only 21 cases involving the scrotum have been previously reported. OBJECTIVE: Our purpose is to describe three additional cases of scrotal BCC and review the literature summarizing the clinical features and identifying any predisposing factors. METHODS: We retrospectively reviewed 21 cases of scrotal BCC and described three new cases. Polymerase chain reaction (PCR) was used to detect human papillomavirus (HPV) DNA in our biopsy specimens. RESULTS: Scrotal BCCs present as persistent ulcerations or plaques without identifiable predisposing factors. Lymphatic, pulmonary, or skin metastases were present in 3 of 24 cases (13%) resulting in death in one case. PCR did not detect HPV DNA in our three cases. CONCLUSION: Scrotal BCC rarely occurs and should be considered in the diagnosis of a persistent scrotal ulcer or plaque. Metastatic disease may be more common than with other BCCs and wide local excision or Mohs micrographic surgery may be the most appropriate initial therapeutic approach.

Aged↗
PubMed1992

Detection with the polymerase chain reaction of human papillomavirus DNA in condylomata acuminata treated in vitro with liquid nitrogen, trichloroacetic acid, and podophyllin.

BACKGROUND: The mechanisms of action for local treatments used against condylomata acuminata are unknown, but most are believed to cause physical destruction of infected tissue. OBJECTIVE: Our purpose was to determine whether liquid nitrogen, trichloroacetic acid (TCA), and podophyllin damage HPV DNA found in condylomata acuminata. METHODS: Fourteen genital warts were excised from 14 patients and divided. One part was treated with liquid nitrogen, the second and third parts were treated with TCA and podophyllin, respectively, and the remainder served as a control. DNA was then extracted from tissue by proteolytic digestion and amplified by the polymerase chain reaction. Dot blots were performed with the use of radiolabeled consensus and HPV type-specific probes. RESULTS: HPV DNA was amplified and detected in 100% of untreated specimens, in 92% of specimens treated with liquid nitrogen, and in 15% and 7% of specimens treated with podophyllin and TCA, respectively. CONCLUSION: TCA and podophyllin damage HPV DNA more effectively than does liquid nitrogen.

Biopsy↗
PubMed1992

Human papillomavirus type 6 infection involving cutaneous nongenital sites.

Human papillomavirus (HPV) type 6 is classically considered a mucosatropic virus. Interestingly, clinical manifestations of HPV 6 infection that involve nonmucosal or nongenital sites have rarely been described. The reasons for this site specific infectivity of HPV 6 are unknown. We describe a patient who had condylomata acuminata-like lesions that involved cutaneous nongenital sites; HPV 6 DNA was detected in skin biopsy specimens with use of the polymerase chain reaction, followed by hybridization with use of type-specific DNA probes.

Arm↗
PubMed1992

Pool palms.

Explore the source record for details and available documents.

Child, Preschool↗
PubMed1992

Porphyria cutanea tarda and human immunodeficiency virus infection.

Porphyria cutanea tarda (PCT), a relatively uncommon disease, has recently been reported in patients infected with the human immunodeficiency virus (HIV). Although PCT and HIV infection may co-exist by chance, the increasing number of reported cases suggest that HIV or an associated factor triggers the development of PCT in predisposed individuals. We report four additional cases of PCT in HIV seropositive patients and review the previously reported cases. The possible links between PCT and HIV are discussed. We believe the diagnosis of PCT should prompt investigation for HIV infection in all patients.

Adult↗
PubMed1991

Pityriasis rubra pilaris and HIV infection.

Many cutaneous diseases have been reported in patients with human immunodeficiency virus infection. We report two patients with pityriasis rubra pilaris and human immunodeficiency virus infection. In one patient, the onset of pityriasis rubra pilaris preceded the discovery of human immunodeficiency virus infection. In the second patient, the onset of pityriasis rubra pilaris occurred shortly after the patient tested positive for human immunodeficiency virus infection. Both patients had a severe form of pityriasis rubra pilaris, and both had a minimal therapeutic response to etretinate.

Adult↗
PubMed1991

Idiopathic and L-tryptophan-associated eosinophilic fasciitis before and after L-tryptophan contamination.

Recently, a causative association has been made between the ingestion of levotryptophan (L-tryptophan) and the eosinophilia-myalgia syndrome (EMS), a new entity manifested by peripheral blood eosinophilia, myalgias, constitutional symptoms, and cutaneous edema with fibrosis. Contaminated levotryptophan preparations produced at a single manufacturing company between October 1988 and June 1989 have been implicated in all EMS cases. In this study, we analyzed retrospectively 49 patients with cutaneous fibrosis for a history of levotryptophan use. Levotryptophan ingestion prior to the onset of their disease was reported by 11 (65%) of 17 patients with eosinophilic fascilitis (EF), two (20%) of 10 patients with localized scleroderma, and none of 22 patients with systemic sclerosis. The onset of levotryptophan-associated cutaneous disease preceded the availability of contaminated levotryptophan preparations in seven (54%) of 13 patients. One patient with levotryptophan-associated generalized morphea also had lichen sclerosus et atrophicus and acanthosis nigricans, findings not previously reported in patients with EMS. In addition, we compared the clinical and laboratory features of levotryptophan-associated EF and idiopathic EF. Myalgias, muscle weakness, paresthesias, morpheaform plaques, cutaneous ulcers, and livedo reticularis were more common in patients with levotryptophan-associated EF. We conclude that levotryptophan-associated EF and localized scleroderma were present before the presumed date of contaminated levotryptophan availability. The clinical spectrum of cutaneous fibrosis associated with the ingestion of levotryptophan includes generalized morphea and EF, which are similar though not identical to their idiopathic counterparts.

Adult↗
PubMed1988

Long-term radiographic follow-up after isotretinoin therapy.

We evaluated the effects of long- and short-term isotretinoin therapy on the skeletons of patients. Eight patients who were treated with isotretinoin for disorders of keratinization received frequent radiographic evaluations for 4 to 9 years. Seven patients developed multiple hyperostoses at the spine and extremities. Hyperostoses increased in size and number over the course of therapy, although relatively few sites were symptomatic. Hyperostoses typically developed first in the spine and later in the extremities, where both bilaterally symmetric and asymmetric involvement was observed. After 5 years of therapy one patient did not develop hyperostosis. In a group of nine patients who received a relatively high dose of isotretinoin in 1982 for the treatment of acne, two patients developed tiny, asymptomatic hyperostoses. One patient had hyperostoses 1 year after isotretinoin therapy, which remained unchanged 3 years later, whereas the other patient had one hyperostosis 4 years after therapy had been stopped. Although we suspect that these hyperostoses were retinoid induced, they should not be of concern for the patient needing routine isotretinoin therapy for the treatment of cystic acne.

Acne Vulgaris↗
PubMed1988

Angiosarcoma of the adrenal gland.

We report the first case of primary angiosarcoma of the adrenal gland, to our knowledge. A 54-year-old man presented with chronic left upper quadrant abdominal pain, and a left adrenal mass was subsequently found on computed tomography of the abdomen. The tumor was surgically removed and a diagnosis of adrenal angiosarcoma, supported by findings of immunoperoxidase and ultrastructural studies, was made. Seven months later, recurrent tumor resulted in an en bloc resection of lateral gastric wall, tail of pancreas, left kidney, and spleen. One year after the initial surgery, the patient was free of tumor. Angiosarcoma should be added to the list of possible primary adrenal gland malignancies.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

HIV-Dendritic cell interactions promote efficient viral infection of T cells.

Dendritic cells (DC) are bone marrow-derived leukocytes that act as powerful stimulators of primary and secondary immune responses. Langerhans cells (LC), which are immature DC in epidermis and genital mucosa, are generally believed to be the initial cells infected with HIV following mucosal exposure to virus. Interestingly, freshly isolated LC express the HIV coreceptor CCR5, but not CXCR4, on their cell surfaces. This expression pattern would theoretically allow only macrophage-tropic [and not T cell (TC)-tropic] HIV to be transmitted across intact mucosal epithelium. In vitro, it is known that HIV infects LC (and other DC) in a CD4- and HIV coreceptor-dependent manner. In addition, HIV can be captured by prominent stellate processes on the surface of LC/DC. HIV-infected DC, as well as DC that have captured HIV, efficiently transmit virus to TC during antigen-specific TC activation. Thus, DC may be involved in HIV plasma viremia increases observed following antigenic exposure, e.g. immunizations, in chronically HIV-infected individuals by (1) activating latently infected TC or (2) activating and transmitting virus to new target TC. In summary, DC most likely play a major role in primary HIV infection by allowing virus to breach mucosal surfaces, and can act during both initial and chronic phases of HIV disease by facilitating infection and depletion of TC.

Antigens, CD↗
PubMedDate not supplied

Morphogenesis of HHV8 in primary human dermal microvascular endothelium and primary effusion lymphomas.

This study elucidates the morphology of HHV8 replication in human dermal endothelial cells and primary effusion lymphomas (PEL) and compares it to that seen in Kaposi sarcoma. Primary human dermal microvascular endothelial cells (DMVEC) exposed to the cell-filtered supernatant of the PEL JSC1 and PEL cell lines (KS-1, BCBL-1, BC-1, BC-3) were cultured in the presence or absence of 12-O-tetradecanoyl-phorbol-13-acetate (TPA) or butyrate. Cells were fixed in neutral-buffered glutaraldehyde, gelled in cooled agar, and processed for TEM. There was a quantitative, but not a qualitative difference in viral expression associated with no treatment or exposure to TPA or butyrate of H HV8 in DMVEC and PEL. Two types of viral-induced intranuclear inclusions (INI) were visible at the light and ultrastructural levels. The more common INI had lighter staining material filling the nucleus, except for a rim of dense chromatin, and could be seen even before viral nucleocapsids (NC) were visible. The second type of INI resembled a target formed by condensation of electron-dense material surrounded by a lighter halo and marginated heterochromatin and containing NC. Collections of coalescing electron-dense granules resembling starbursts were often present in nuclei containing either type of INI. Next to appear in productively infected cells were mature enveloped particles that formed mostly by the budding of NC into cytoplasmic vacuoles. Mature particles were also seen free on the plasma membrane. Tufts of electron-dense intermediate filaments were associated with maturing particles. Mature virions lacked an electron-dense tegument. Viral production was ultimately associated with cell lysis. It appears that HHV8 propagate in DMVEC, with and without stimulation, and have a similar morphogenesis to that seen in PEL cell lines and Kaposi sarcoma lesions. Several unique features characterize cells productively infected by HHV8.

Butyrates↗