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Biomedical subjects

A R Solomon

Publications and source records attributed to A R Solomon.

At least 73 records · Page 4Linked to original sources
PubMed1986

A comparison of the Tzanck smear and viral isolation in varicella and herpes zoster.

We compared the usefulness of the Tzanck smear to viral culture in patients with varicella and herpes zoster. All 11 patients with early lesions of varicella had a positive Tzanck preparation, while only seven (64%) of 11 had a positive culture. Twelve (80%) of 15 patients with zoster had a positive Tzanck preparation, while only nine (60%) of 15 had a positive culture. The predominance of the Tzanck yield over the culture is probably due to the increased difficulty in isolation of the varicella zoster virus. These results suggest that the Tzanck preparation is a valuable tool in the diagnosis of patients with varicella and zoster and offers a much more immediate answer than does viral culture, which often takes one to two weeks. These results contrast with those of our previous study of the Tzanck preparation and herpes simplex, in which the viral culture was more accurate than the Tzanck preparation.

Adolescent↗
PubMed1986

Mechanism-oriented assessment of isotretinoin in chronic or subacute cutaneous lupus erythematosus.

Eight of ten patients with chronic or subacute cutaneous lupus erythematosus completed 16 weeks of oral isotretinoin therapy (80 mg/day). All eight patients noted an excellent clinical response without significant side effects. (Two patients did not return to initial two-week follow-up.) Peripheral blood B- and T-cell counts were unaffected by therapy. Therapy was associated with resolution of routine histopathologic abnormalities, conversion of abnormal lesional direct immunofluorescence microscopy to normal, normalization of the epidermis on electron microscopy, and reduction of all T cells near the dermoepidermal junction without change in ratio of T-helper/inducer cells to T-suppressor/cytotoxic cells. Isotretinoin is a clinically effective short-term therapy for chronic or possibly for subacute cutaneous lupus erythematosus. The primary mechanism of action remains unestablished.

Administration, Oral↗
PubMed1986

Sporotrichosis masquerading as pyoderma gangrenosum.

A 46-year-old man was diagnosed as having pyoderma gangrenosum after special stains and cultures from a skin biopsy specimen were reported as negative. Cutaneous sporotrichosis is usually diagnosed with relative ease on the basis of clinicopathologic features and prompt growth of the fungus in culture, although organisms are difficult to detect in tissue even with special stains. Identification of Sporothrix schenckii was delayed for three months in this patient because of unusual growth characteristics noted in the culture. The report of this patient's clinical course illustrates both the need to frequently reassess the diagnosis of pyoderma gangrenosum in treatment-resistant patients and the fact that S schenckii may be difficult to diagnose clinically and mycologically if the growth characteristics of the fungus are unusual.

Dermatomycoses↗
PubMed1986

Disseminated Nocardia brasiliensis infection following cryptococcal disease.

Nocardiosis is an increasing clinical problem, especially in immunocompromised patients. The offending species is almost always Nocardia asteroides. Cryptococcosis is also an increasing problem in the immunosuppressed. We describe a patient with probable disseminated cryptococcosis followed by disseminated Nocardia brasiliensis infection. Only eight patients with disseminated N brasiliensis infection have been described, to our knowledge, in the United States.

Cryptococcosis↗
PubMed1986

Thalidomide effects in Behçet's syndrome and pustular vasculitis.

Pustular vasculitis is a new disease concept that links cutaneous, and possibly systemic, aspects of Behçet's, bowel bypass, bowel-associated dermatosis-arthritis, and disseminated gonorrhea syndromes. The pathomechanism of pustular vasculitic lesion generation may relate to circulating immune complex (CIC)-mediated vessel damage and serum enhancement of neutrophil migration. Thalidomide, an oral pharmaceutical available on strict protocol, has therapeutic effects based on proposed modulation of CIC- and neutrophil-mediated cytotoxicity. Thalidomide therapy was started for four patients with significant morbidity from Behçet's syndrome and for one patient with bowel-associated dermatosis-arthritis syndrome. Clinical benefit was dramatic in all patients who completed sequential four-week "on" and "off" thalidomide therapeutic cycles. In three of four patients, in vivo testing for CIC after histamine injection immunopathology converted from positive (immunoreactant deposition in dermal vasculature [four hours after histamine] and CIC-mediated vasculitis [24 hours after histamine]) to negative during therapy. No effects were noted on neutrophil migration or on the LFA-1/Mac-1/p150,95 family of glycoproteins associated with neutrophil adherence as assessed qualitatively by tritium labelling of neutrophil cell surfaces. In this small patient group, thalidomide was a clinically effective, safe (with rigid monitoring) therapy whose mechanism of action may relate more to inhibitory effects on CIC-induced vasculitis than to effects on neutrophil-mediated cytotoxicity.

Antigen-Antibody Complex↗
PubMed1985

Complex aphthosis: a forme fruste of Behçet's syndrome?

The evaluation of the rare patient who presents with oral and genital aphthae or almost constant, multiple (greater than 3) oral aphthae, but no systemic signs or symptoms (i.e., complex aphthosis), is difficult because no laboratory test is available to exclude Behçet's syndrome. Six patients with complex aphthosis were evaluated. In addition, patients with simple aphthosis, those with seronegative arthritis, and normal controls were assessed for circulating immune complexes (CIC) by in vitro and in vivo assays and for neutrophil migration by subagarose methods, since these tests have given significant results in patients with Behçet's syndrome. Patient 1, with complex aphthosis, had Raji cell evidence for CIC (51.2 mg aggregated human gamma globulin Eq/ml), C1q, and C3 in dermal blood vessels 4 hours post intradermal histamine injection and had a Sweet's syndrome-like vasculitis 24 hours post histamine injection. In addition, her serum enhanced the migration of patient neutrophils (3.6 +/- 0.6 to 4.6 +/- 0.5; N = 6, p less than or equal to 0.01). All other test and control patients had negative or normal CIC and neutrophil migration determinations. Sixteen-month clinical follow-up has confirmed that Patient 1, but not Patients 2 to 6, has developed overt manifestations of Behçet's syndrome.

Adult↗
PubMed1985

Polymyositis presenting with panniculitis.

Although microscopic areas of panniculitis may frequently occur in patients with dermatomyositis and polymyositis, large, clinically obvious plaques are unusual. We report a patient with polymyositis who initially had panniculitis of the thigh. Histologically, a lobular lymphoplasmacytic infiltrate was present in the subcutis.

Female↗
PubMed1985

Coexistent systemic lupus erythematosus and tophaceous gout.

Only seven patients with coexistent gout and systemic lupus erythematosus have been reported in the English-language literature. We describe an eighth case, which is the first, to our knowledge, in the dermatologic literature. The patient met four of the eleven new American Rheumatism Association criteria for the diagnosis of systemic lupus erythematosus, and clinical, laboratory, roentgenographic, and histologic assessments confirmed the diagnosis of gout.

Adult↗
PubMed1985

Pyoderma gangrenosum and chronic persistent hepatitis.

Pyoderma gangrenosum is a diagnosis of exclusion. A 36-year-old woman was clinically diagnosed as having pyoderma gangrenosum and appropriate exclusion tests were performed. Pyoderma gangrenosum may occur in association with underlying diseases such as leukemia, monoclonal gammopathy, inflammatory bowel disease, arthritis, and chronic active hepatitis. However, these diseases were excluded in this patient who did have chronic persistent hepatitis. To our knowledge, this is the first reported case of chronic persistent hepatitis and pyoderma gangrenosum.

Adult↗
PubMed1985

Localized vulvar pemphigoid in a child.

Bullous pemphigoid often affects the elderly but is not common in children. At least two localized variants, cicatricial pemphigoid and localized, chronic pemphigoid of Brunsting-Perry, have been described. A case of bullous pemphigoid in a 9-year-old girl was unusual because erosions were limited to the vulvar area. Other bullous dermatoses were considered in the differential diagnosis. Histopathologic examination and immunofluorescence microscopic studies, as well as immunoelectron microscopic studies, which yielded unique results, were performed to confirm the diagnosis.

Child↗
PubMed1985

Retroviruses and lymphoproliferative disease.

This article has provided an introduction to and a brief overview of recent developments in the investigation of retroviruses and their role in animal and human neoplasia. The sheer volume of new information concerning this subject is nearly overwhelming. We can only hope that this knowledge will eventually lead to major therapeutic advances.

Deltaretrovirus↗
PubMed1985

Behçet's syndrome. Immunopathologic and histopathologic assessment of pathergy lesions is useful in diagnosis and follow-up.

Behçet's syndrome is a complex multisystem disease that, due to the absence of a pathognomonic laboratory test, must be diagnosed using clinical criteria. Clinical pathergy testing, the induction of a sterile pustule 24 hours after cutaneous trauma, has been proposed as a useful adjunct to diagnosis. We have expanded this concept by showing the usefulness of examining pathergy lesions by routine and immunofluorescence microscopy in the diagnosis of nine patients with Behçet's syndrome. Furthermore, histopathologic pathergy assessments correlated with clinical disease activity and/or response to experimental oral thalidomide therapy in five of six patients with Behçet's syndrome who were retested.

Adult↗
PubMed1985

Acquired dermal smooth-muscle hamartoma.

We report a patient with a hyperpigmented, non-hairy plaque on the forearm. The presence of disorganized smooth-muscle bundles within the dermis proved this lesion to be a dermal smooth-muscle hamartoma. The relationship of this lesion to the pigmented hairy nevus of Becker is discussed.

Adult↗
PubMed1985

The histologic spectrum of the reactive inflammatory vascular dermatoses.

The varied histopathology of the reactive inflammatory vascular dermatoses requires close cooperation between the clinician and the pathologist. This article presents an overview of the histology of this group of dermatoses, including the figurate erythemas, the pigmented purpuric eruptions, urticaria and urticarial vasculitis, Sweet's syndrome, erythema multiforme, and erythema nodosum.

Dermatitis↗
PubMed1984

The Tzanck smear in the diagnosis of cutaneous herpes simplex.

We examined the effectiveness of the Tzanck preparation compared with viral isolation in 32 lesions of cutaneous herpes simplex infection in 30 consecutive patients. Seventy-eight percent had positive cultures, even though the clinical history and lesion morphological findings were typical in all situations. Other authors have also noted that viral isolation does not reach 100% even in the face of typical clinical history. Fifty-three percent of the Tzanck smears were positive. These preparations had a high correlation with positive viral cultures (94.1%). Vesicles were more likely to yield a positive culture than Tzanck smear (100% and 66.7%, respectively). Pustules yielded positive cultures in 72.8% and positive Tzanck smears in 54.5%, while crusted-ulcer lesions were usually not positive by either technique (34%, 16%). A positive Tzanck preparation is an accurate, rapid tool for the diagnosis of cutaneous herpes simplex.

Cytodiagnosis↗
PubMed1984

Apocrine cystadenoma arising in a nevus sebaceus of Jadassohn.

An increased incidence of benign and malignant adnexal tumors has been noted to occur within the nevus sebaceus of Jadassohn. We report a case of a 41-year-old white woman with a blue cyst on her scalp which had recently developed within a congenital "birthmark." Excision of the lesion revealed that the nodule was an apocrine cystadenoma within a nevus sebaceus of Jadassohn. The clinical features of nevus sebaceus with apocrine cystadenoma are discussed and the various tumors which may arise within the nevus sebaceus are reviewed.

Cystadenoma↗
PubMed1983

An evaluation of vertical growth in thin superficial spreading melanomas by sequential serial microscopic sections.

In the decade since Breslow first described the technique of measuring tumor thickness in cutaneous melanoma and its prognostic significance, this measurement has become an integral part of the histologic evaluation of these tumors. In an attempt to define the effect of specimen sampling on this measurement, the authors compared their routine sampling method in which microscopic sections were examined at consecutive 3 mm intervals with one utilizing sequential microscopic serial sections of approximately 5 microns each in 19 cases of thin (less than 0.76 mm in depth) superficial spreading melanomas. All cases showed an increase in the measured maximum tumor thickness when serially sectioned, but neither deep dermal extension of melanoma nor angiolymphatic invasion by tumor were observed. Measured thickness in thin cutaneous melanoma is a function of the number of sections examined. The method of specimen sampling needs to be carefully defined and standardized in studies that attempt to define prognosis on the basis of tumor thickness. It is proposed that the routine sampling technique of the authors meets these criteria and that it be adopted as a standardized method of examining pigmented cutaneous specimens.

Adult↗