Biomedical subjects
A Kint
Publications and source records attributed to A Kint.
Histopathologic study of Koenen tumors. Are they different from acquired digital fibrokeratoma?
Fifteen periungual fibromas from nine patients were studied histologically. The lesions were elongated. Capillaries were found in the distal part surrounded by thin collagen bundles whereas the proximal part was made up of dense, closely packed fibers. The epidermis covering the tumor appeared to be connected with the nail fold. The dense collagen of the lesion faded into the normal structure of the cutis of the proximal nail fold. Periungual fibromas can be subdivided into (1) fibrokeratomas originating from the dermal connective tissue and (2) fibrokeratomas originating from the proximal nail fold.
Pseudo-Kaposi's sarcoma as a complication of Cimino-Brescia arteriovenous fistulas in hemodialysis patients.
Pseudo-Kaposi's sarcoma is a skin lesion that is associated with chronic venous insufficiency and/or congenital arteriovenous fistulas. Theoretically, this lesion could also be expected in connection with hemodialysis vascular accesses. Nevertheless, this disease has been reported only once in conjunction with a Cimino-Brescia arteriovenous fistula, and no attention has been paid to the potential complications of this disease. In the present paper 3 cases are reported. In 1 patient pseudo-Kaposi's sarcoma was complicated by an infected open wound as a consequence of a trauma. In the 2 other patients, a skin biopsy was followed by local infection and retarded healing of the wound. Evaluation by fistulagraphy and/or Doppler revealed venous outflow stenosis in only 1 case. After reconstruction or ligation of the fistula, correction of the lesions was observed. It is concluded that pseudo-Kaposi's sarcoma can occur as a complication of Cimino-Brescia arteriovenous fistulas, necessitating early correction of the fistula. The performance of a skin biopsy might be associated with infection and delayed wound healing, so that this diagnostic procedure should only be performed in cases where the clinical diagnosis is not obvious.
Multiple clear cell acanthomas. A clinical, histological, and ultrastructural report.
A case of multiple clear cell acanthomas in a 64-year-old woman is reported. The clinical and histological findings of this rare entity are consistent with the hypothesis that clear cell acanthomas are benign epidermal tumors. An ultrastructural study was performed with special emphasis on the melanocytic-keratinocytic interaction.
[Congenital diffuse melanosis].
Two cases of diffuse congenital melanosis are presented. The hyperpigmentation appeared shortly after birth and invades progressively the trunk and the limbs. It is diffuse and most intensive on the abdomen and the back, and reticulated on the neck, the genitals and in the groins. The nails are thin and their surface is slightly irregular. Histologic examination reveals the presence of melanin in the deep and superficial layers of the epidermis. On electron microscopy the melanosomes are not grouped within the keratinocytes, but are dispersed throughout the cytoplasm of the epidermal cells. The disease can be considered as an autonomous entity. The mechanism of the hyperpigmentation is not known.
Hypotensive attacks due to systemic mastocytosis.
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[Dysplastic nevus syndrome].
Dysplastic nevus syndrome is an autosomally dominant disease, which may develop hereditary malignant melanoma. Dysplastic nevi are found anywhere on the body surface and show definite clinical characteristics. Histologic examination reveals atypical melanocytes at the dermo-epidermal junction and inflammatory infiltration in the dermis. The dysplastic cells show either lentiginous or epithelioid dysplasia. The evolution towards malignant melanoma always starts with the development of epithelioid melanocytes in the epidermis. Sunlight might further the mechanism of degeneration. Thus dysplastic nevus syndrome becomes important for the possible recognition and prevention of potential malignant melanoma.
Livedo racemosa generalisata and stroke.
The authors describe three young female patients with generalized livedo racemosa and cerebral infarction. The radiologic and biopsy findings point to a widespread vasculopathy, involving small and mid-sized arteries. The histologic examination of the temporal artery biopsy in two patients gives additional evidence for a chronic endarteritis as possible underlying cause of this disease entity.
Acquired (digital) fibrokeratoma.
Histologic examination of fifty cases of acquired digital fibrokeratoma discloses three histologic variants of these lesions, viz: a tumor composed of thick dense and closely packed collagen bundles, a variant with an increased number of fibroblasts in the cutis, and a type with an edematous and poorly cellular structure. The acquired digital fibrokeratoma is considered as resulting from a neoformation of collagen by the fibroblasts. The acanthosis of the epidermis is probably secondary to the dermal alteration.
Dermatitis artefacta.
Self-inflicted dermatoses mainly refer to psychiatric disturbances such as psychoses, mental retardation, and personality disorders. Diagnostic clues are found in the nature and the evolution of the lesions as well as in the ambivalent combination of dependency on doctors and hostility toward them revealed in the patient's medical history. Management of dermatitis artefacta patients means dealing with the complex emotional issue of a basic antagonism in the dermatologist-patient relationship. Both the dermatologist and the dermatologic nursing staff should show an understanding and nonaggressive attitude.
Mycosis fungoides and lymphoplasmacytoid immunocytoma in the same patient. A case report.
The simultaneous occurrence of two different lymphomas in a 57-year-old white woman is reported: mycosis fungoides and a leukemic lymphoplasmacytoid immunocytoma. The first was confirmed by histologic study and electron microscopy, and the latter by histologic study and immunoperoxidase staining. The lymphoid cells in the involved bone marrow and peripheral blood expressed the same surface immunoglobulin as was found in the cytoplasm of the immunocytoma cells, i.e., IgM-lambda. The clonal B-cell expansion was brought into a lasting remission by chlorambucil, but the cutaneous lymphoma proved to be refractory to therapy. The patient died 38 months after diagnosis.
Primary management of melanoma.
A questionnaire was sent to all consultant dermatologists in The Netherlands, Belgium and Scotland regarding their management of suspected melanomas. The 343 evaluable responses showed that 29.7% of the dermatologists regularly prefer to 'wait and see' or carry out incisional biopsies in the early management of suspected melanoma, especially if the risk is thought low. The main arguments advanced by the proponents of incision were doubts about whether incisional biopsy provokes metastatic spread, and the belief that a pathologist can make reliable diagnosis on a partial specimen of the tumour. These arguments are questioned and excision biopsy, provided it is feasible without being disfiguring, is strongly recommended in the initial treatment of a suspected melanoma.
Alopecia areata: a clinical study.
100 cases of alopecia areata are examined and the possible relationship with the presumed etiological factors (atopy, autoimmunity and psychosomatics) are looked for. When atopy or autoantibodies are present alopecia areata always runs a serve course. It is, however, impossible to establish a definite etiological relation between atopy or autoimmunity and alopecia areata.
Halomethasone (C 48.401-Ba) for the topical treatment of common dermatoses.
C 48.401-Ba cream, containing 0.05% halomethasone was compared in a double-blind between-patients trial with a cream containing 0.1% betamethasone valerate in forty-eight patients suffering from atopic dermatitis and in thirty-nine patients suffering from seborrhoeic dermatitis. A similar comparison was made with ointments containing the same concentration of active ingredient in forty-six patients suffering from atopic dermatitis. Both ointments were also compared in a within-patient double-blind trial in thirty patients suffering from psoriasis. The analysis of the results showed that for the treatment of the above-mentioned dermatoses, both drugs, the cream as well as the ointment, are equally effective and well tolerated.
Treatment of alopecia areata with dinitrochlorobenzene.
Thirty patients with severe alopecia areata (A. A.) were treated with weekly applications of dinitrochlorobenzene (DNCB) in acetone solution. In only four patients regrowth of hair was complete and dense; sixteen patients experienced temporary results and in ten the treatment was a failure.
Reticular telangiectatic erythema after implantation of a pacemaker.
A case of a telangiectatic erythema appearing after implantation of a pacemaker is described. The eruption cleared completely after removal of the battery.
[Indications for retinoids].
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