Cutaneous syndromes of systemic disease and clinical observations with Proper MYL therapy.
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Humans↗
Biomedical subjects
A Massa
Publications and source records attributed to A Massa.
Clinical evaluation of metabolic changes induced by the use of a new steroid in immature infants and in various other pathological conditions.
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Anabolic Agents↗
Immediate and delayed hypersensitivity to mite antigens in atopic dermatitis.
Atopic dermatitis (AD) is a common disorder and appears to be on the increase, especially among children. It was thought at first to be a manifestation of immediate hypersensitivity, but it is now known that delayed hypersensitivity also plays an important role. Sensitivity to mite antigens is found in 20% to 60% of patients when immediate hypersensitivity is evaluated by the detection of specific IgE antibodies and prick tests, and in 30% to 50% of patients when delayed hypersensitivity is studied by patch testing. A prospective randomized study was carried out in the pediatric dermatology clinic on a sample of 51 children under 15 years of age. A prevalence of immediate and delayed hypersensitivity to mites, like that described for other populations, was found. It was further found that there was a positive association, not described in the literature, between the younger age groups and delayed hypersensitivity to mite antigens, while the opposite was true for immediate hypersensitivity. We believe that patch tests with airborne allergens, specifically mites, should be part of the protocol for assessing children with AD, particularly in the younger age groups.
Age of Onset↗
Two recent cases of tertiary syphilis.
Tertiary syphilis is now a rare disease in Europe, mainly as a result of occasional antibiotherapy for concomitant infections. However early syphilis is rising in USA and Germany, and it is necessary to maintain an high level of knowledge and suspicion to achieve a diagnosis in the tertiary stage of the disease. In this report two patients with benign tertiary syphilis are described. The first one is a 55-year-old female with erythemato-violaceous annular scaling plaques on the right buttock and scapula and on both thighs, which had a negative and then a low VDRL titer. The second case is a 33-year-old mentally handicapped female with erythematous plaques, with psoriasiform scaling in the trunk and well defined crusted ulcers on the face, which also had negative VDRL. Biopsy of the skin lesions revealed plasmocytic infiltrate with endothelial swelling without granulomas and with negative silver stains in both patients. The investigation for cardiovascular and neurological involvement was negative in both patients. Diagnosis of tertiary syphilis can be difficult as clinical pictures can be misleading, similar to other granulomatous diseases, and serological titers can be low or negative. We recall the necessity of ruling out neurological and cardiac involvement in this stage of syphilis. These cases are reported as a reminder of the possibility of syphilis, so that new cases are not misdiagnosed and mistreated as other diseases.
Adult↗
[Prevalence of cutaneous lesions in Freixo de Espada à Cinta].
Incidence or prevalence studies on cutaneous lesions in general populations are not available. The community observed by the authors (Freixo de Espada à Cinta, North-Eastern Portugal) is relatively closed. A pre-tested questionnaire for socio-demographic and clinical information was used and a physical observation was conducted in January and February 1994 by the Dermatology Team of Santo António General Hospital, Oporto. The analysis was supported by independent tests (Pearson and Fisher chi 2, Student-t, Mann-Whitney and Kruskall-Wallis). The Spearman correlation coefficient was also used. The results indicated that 51.9% of 1000 subjects analysed were in phototype III. Concerning specific pathologies, the following percentages were observed: melanocytic nevi 81.2; hemangiomas 26.5; androgenetic alopecia 20.5; deshydrotic eczema 12.7; seborrheic keratosis 11; solar keratosis 9.6; acne vulgaris 9.5; seborrheic dermatitis 6.9; superficial mycosis 6.4; other dermatitis 5.5; vascular spiders 4.4; vulgar psoriasis 1.9; vulgar warts 1.5; pediculosis and scabiosis 1.2.; herpes simplex 0.9; impetigo 0.7; tumours (neoplasias) 0.7; dysplastic nevi 0.6; urticaria 0.3. More than nine nevi were counted in 50% of the subjects observed. A difference was observed (p < 0.05) concerning the presence of nevi, mycosis, hemangiomas, non-specific dermatitis, vascular spider and solar keratosis according to sex. The females had more nevi in number than males (Mann-Whitney, p = 0.03). According to age there was a difference concerning the presence of nevi, superficial mycosis, deshydrotic eczema, seborrheic dermatitis, acne, psoriasis, tumours, hemangiomas, non-specific dermatitis, vascular spider, solar keratosis (with linear augmentation by age) and seborrheic keratosis. Nevi increased with ageing (Rs = 0.10 p < 0.001) and a greater number were observed in age groups 0-9 and 60 or more years. Acne was observed in 9.4% of the females and 9.7% of the males, 46.2% in the 15-29 year-old age group. This study indicated that the population had a mean of nine nevi. Psoriasis was similar to that mentioned in other studies: about 1% in the United States of America. Atopic dermatitis (5.5%) is below the values for the northern population (> = 15%), but above that indicated for the English and American population. Nevertheless, the values of the present study were higher than those in the latter populations, when children until seven years old were considered. The Freixo de Espada à Cinta population above 60 years had solar keratosis in 30.6%, a value three times higher than the previous decade (10.9%); reference values were not found. Contrary to the literature, an association was not established between phototype and solar keratosis. Cutaneous tumours were observed in 0.7% of the cases.
Adolescent↗
Cutaneous necrobiotic xanthogranuloma (NXG)--successfully treated with low dose chlorambucil.
We report a case of necrobiotic xanthogranuloma in a 51 year-old white male patient presenting with a 6-year history of multiple indurated violaceous nodules and plaques involving the eyelids, trunk and extremities. He had an associated paraproteinemia (Ig G lambda), elevated sedimentation rate, cryoglobulinemia and hypocomplementemia. No extracutaneous involvement was detected. He was successfully treated with chlorambucil (2 mg/d for 7 months), leading to disappearance of all skin lesions.
Adult↗
Behaviour of several 'progression markers' during the HIV-Ab seroconversion period. Comparison with later stages.
Two acute phase reactants, four cytokines, five soluble factors and lymphocyte subpopulations have been simultaneously evaluated in 16 subjects before and closely after the HIV-Ab seroconversion time. The same variables have also been determined in 50 HIV-Ab-negative high risk subjects, in 36 CDC II-III and in 30 CDC IV patients, utilizing a mixed longitudinal epidemiological model. The results show significant variations of few parameters in the early phases (increase: sCD8, beta-2-Microglobulin, sIL-2R, sCD23, Neopterin, IFN-alpha; decrease: CD4+ lymphocytes). In the course of the disease, many others parameters progressively increase (IFN-tau, IL-4, IL-6, acid-alpha 1-glycoprotein, alpha 1-antitrypsin) or decrease (B- and T-lymphocytes). Ferritin, in particular, highly increases only in CDC IV stage. These data may be useful to monitor patients during the entire course of their disease and to suggest the time elapsed from seroconversion.
Acute-Phase Proteins↗
[Acanthosis nigricans and cancer of the stomach].
A case of a 44 years old patient with inoperable gastric adenocarcinoma and exuberant lesions of Acanthosis Nigricans is described. He died nine months after the diagnosis, having experienced disappearance of the cutaneous manifestations after the cytostatic treatment done. The literature about Acanthosis Nigricans is reviewed and the importance of precocious search of associated malign disease is stressed. It was demonstrated by immunocytochemistry, positivity to NSE (neuron specific enolase) and ACTH, in the patient gastric tumour cells which allows them to be classified as neuroendocrine cells. It is suggested that Acanthosis Nigricans is a manifestation of a para-endocrine syndrome.
Acanthosis Nigricans↗
[Hemoglobin H disease. Presentation of a case].
Haemoglobin H (Hb H) disease, the most important clinical form of alpha-thalassaemia, shows remarkable clinical variability. Hb H si an unstable tetramer of beta-globin chains which accumulates because of the lack of adequate numbers of alpha-globin chains and precipitates in the red cells, causing their premature destruction. A case of Hb H disease in a 9-yr-old child, admitted into hospital for acute haemolysis after use of pyrazolone derived, is presented. Haematologic data with synthesis in vitro of globin chains were obtained from the parents and sister. The clinical and haematologic features of this form of haemoglobinopathy are briefly discussed in the light of recent knowledges of his genetic mechanism of transmission.
Anti-Inflammatory Agents↗
Beta-thalassemia mutations in Rome. A high frequency of the IVSII-745 allele in subjects of latium origin.
We studied the molecular bases of beta-thalassemia in Rome, a city centrally located in Latium, which is a region with a low incidence of beta-carriers. People also come to Rome from other regions for specific or prenatal diagnostic assessment. Only 11 patients (20%) out of 62 characterized beta-thalassemia subjects were of Latium family origin. They presented five mutations with an uncommonly high frequency of the IVSII-745 allele, that was found in homozygosis in 4 unrelated patients from a southeastern area in the province of Frosinone. These data may indicate a founder effect.
Alleles↗