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Biomedical subjects

A Ilchyshyn

Publications and source records attributed to A Ilchyshyn.

35 records · Page 2Linked to original sources

Erythropoietic protoporphyria presenting in an adult.

Erythropoietic protoporphyria is an inherited disorder of porphyrin metabolism, in which reduced activity of the enzyme ferrochelatase leads to accumulation of protoporphyrins in erythrocytes. Protoporphyrins are photoactivated by ultra-violet light causing tissue damage by release of free oxygen radicals, which manifests as photosensitivity. The majority of cases of erythropoietic protoporphyria present in childhood although sometimes symptoms are delayed until the second decade. We report here a case presenting in adulthood and discuss the risk of liver disease in the condition.

Adult↗

Bleomycin-induced flagellate erythema.

A 56-year-old woman who developed widespread pruritus and flagellate erythema after attempted pleuredesis with bleomycin is described. The raised linear lesions of flagellate erythema could not be reproduced by scratching, and histopathological examination revealed a lymphocytic vasculitis. The rash faded spontaneously over several weeks to leave streaks of post-inflammatory melanoderma which remained for 6 months. The role of scratching and dermographism in the pathogenesis of the bleomycin-specific eruption is discussed.

Bleomycin↗

Prolonged survival in metastatic malignant melanoma associated with vitiligo.

A metastatic malignant melanoma presenting with axillary lymphadenopathy and without a detectable primary lesion is described in a 66-year-old woman. Extensive vitiligo developed 6 years after this diagnosis. There has been no recurrence of melanoma for 10 years following surgical resection of the lymph nodes. The significance of vitiligo and an elusive primary lesion to the favourable prognosis in metastatic malignant melanoma is discussed.

Aged↗

Perianal streptococcal cellulitis with penile involvement.

Perianal streptococcal cellulitis is described occurring in a 5-year-old boy. The condition also involved the penis and presented as a possible case of sexual abuse. The correct diagnosis was established by culturing beta-haemolytic streptococci group A from the penile and perianal skin.

Cellulitis↗

Modulation of phospholipase A2 activity in extracts of lesion-free psoriatic epidermis by alkaline phosphatase and a protein phosphatase inhibitor.

Phospholipase A2 activity is raised in non-lesional psoriatic epidermis compared with normal epidermis. It has been shown that the activity of this enzyme is controlled by an inhibitory protein the inhibitory effect of which is increased by dephosphorylation. Treatment of epidermal extracts with alkaline phosphatase reduced the phospholipase A2 activity, both in normal and in lesion-free psoriatic epidermis. Inclusion of pyrophosphate, a protein phosphatase inhibitor, in the homogenizing medium caused the activity of phospholipase A2 in epidermal extracts from normal and lesion-free epidermis to be raised to the same high level. These results are consistent with the hypothesis that the raised phospholipase A2 activity in psoriatic epidermis is due to hyperphosphorylation of an endogenous inhibitor as a result of defective control of a phosphorylation/dephosphorylation mechanism. The relevance of these findings to other work is discussed.

Alkaline Phosphatase↗

Lymphomatoid granulomatosis mimicking bronchial carcinoma.

This report concerns a patient with lymphomatoid granulomatosis who presented with multiple ulcerated skin nodules, a solitary pulmonary mass and a cerebral mass. Biopsies taken from the skin and lung lesion showed necrotic tissue only. This combination of physical signs and the initial non-specific histological changes suggested a diagnosis of primary bronchial carcinoma with secondary spread. However, the subsequent temporary improvement and a further histological examination enabled a diagnosis of lymphomatoid granulomatosis to be made and this was confirmed at post-mortem. This report emphasizes the difficulty in obtaining diagnostic material in lymphomatoid granulomatosis and highlights the need to consider this diagnosis in a patient with suspected carcinoma when biopsy material shows necrotic tissue only.

Aged↗

Yellow nail syndrome associated with penicillamine therapy.

A patient is described in whom the nail changes of the yellow nail syndrome developed whilst she was taking penicillamine. Stopping the drug was associated with resolution of the nail changes. The yellow nail syndrome was first described in 1964 (Samman and White), but the cause is still unknown. Impaired lymphatic drainage is thought to be a factor in the pathogenesis, and lymphoedema is often an accompanying feature. We describe a case in which nail changes, typical of those described in the yellow nail syndrome, occurred in a patient treated with d-penicillamine, and in whom the nails reverted to normal on withdrawing the drug. (Received March 15, 1983.)

Adult↗

Raised epidermal phospholipase A2 activity in rheumatoid arthritis.

Epidermal phospholipase A2 (PLA2) in RA patients was significantly higher than in normals (p less than 0.0001) but lower than in psoriatic patients (p less than 0.05). No relationship was observed between PLA2 activity and commonly used measures of rheumatoid disease activity in a cross-sectional study. However, in a longitudinal study change in PLA2 activity correlated strongly with changes in disease activity.

Adult↗