Lichen planus following HBV vaccination: a coincidence?
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Biomedical subjects
Publications and source records attributed to A Rebora.
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We describe 3 cases of papular and nodular mucinosis (PNM), a clinically distinctive cutaneous mucinosis associated with lupus erythematosus (LE), which has received little attention in the dermatologic literature. Histopathology shows deposits of mucin in the dermis without microscopic features of LE, while immunofluorescent studies disclose linear or granular deposits of IgG, IgM and C3 at the dermoepidermal junction. In about 80% of the 14 cases described in the literature, PMN has been associated with systemic LE with prevalent joint and kidney involvement. The possible prognostic significance of this singular dermatosis is discussed.
The production rate and composition of cerumen have been studied in 11 participants (5 men and 6 women), 25 to 42 years old. The cerumen was obtained in January, May, July, and November to investigate the possible influence of the season. Only the triglyceride content decreased from November to July. Sex was not a factor, which supported the hypothesis that sex hormones play a minor role in the production rate of the lipid component of cerumen.
Prevalence and severity of seborrhoeic dermatitis were studied in 150 patients with psychiatric disorders, including schizophrenia, mood disorders, anxiety and organic mental illness. As a control group, we examined 150 patients waiting for surgery and regarded as obviously anxious. Thirty-eight psychiatric patients were found to have seborrhoeic dermatitis, versus 13 in the surgery group. This statistically significant difference was entirely ascribable to patients with depression.
Overlap syndromes (OS) are complex clinical entities in which symptoms and serological profiles of diverse connective tissue diseases, mainly systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS), dermato/polymyositis and Sjögren syndrome, converge in a single patient. On the basis of the personal experience, the Authors try to classify OS from the serological point of view. Six different serological profiles have been recognized. Anti-U1RNP antibodies define the classical mixed connective tissue disease (MCTD) according to Sharp. These patients are probably most common and present with Raynaud's phenomenon and puffy hands which never reach sclerodactily. In Italian patients, the symptoms of lupus erythematosus are not as frequent as in USA patients, probably due to the prevalence of Negroes in the latter. The absence of renal involvement is, instead, common as in other series. The general trend of these patients is towards progressive systemic sclerosis and lung fibrosis. Anti-Ku antibodies define another group of patients with the same clinical symptoms as MCTD and good prognosis. Anti-Ki-SL antibodies, by contrast, characterize a less common group of patients in which the renal and the pulmonary involvement is frequent. Their prognosis is poor. Anti-Sm and anti Ro/SSA antibodies, which are more commonly found in SLE patients, may be detected also in some of the patients with OS who have a poor prognosis. Patients with anti-SSA, for example, have, as in PSS, an early onset and a rapid development of lung fibrosis. Finally, anti-La/SSB antibodies define patients who associate Sjögren syndrome to SLE or PSS.(ABSTRACT TRUNCATED AT 250 WORDS)
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Circumstantial evidence of phototoxicity of nifedipine is poor, being based only on uncontrolled clinical evidence. The authors have assessed nifedipine phototoxicity in vitro by photohemolysis and Candida albicans tests and found it measurable at 10 and 100 micrograms/ml. These dosages exceed the 0.1 microgram/ml blood levels that are usually attained in vivo.
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Two cases of semicircular lipoatrophy and one of annular lipoatrophy are presented. The reasons why semicircular lipoatrophy, annular lipoatrophy, and annular atrophy of the ankles seem to be different clinical entities are discussed.
A patient with generalized cutis laxa-like pseudoxanthoma elasticum was found to have a congenital deficiency of vitamin K-dependent coagulation factors II, VII, IX, and X. This association may not be fortutious and may define a particular subset of pseudoxanthoma elasticum with an autosomal recessive inheritance and the clinical features of generalized cutis laxa.
We describe a patient with discoid lupus erythematosus who developed annular lesions of the thigh and chilblainlike lesions of the fingers matching those described in the original reports of Rowell's syndrome. The patient also had circulating anti-Ro(SS-A) antibodies whose similarity to the anti-Sj-T antibodies found in the original Rowell's syndrome cases has been recently claimed. A review of the literature suggests that most of the cases of Rowell's syndrome described thus far in fact may be cases of coincidental association of lupus erythematosus and erythema multiforme.
Three patients are described with clinical features of connective tissue diseases, namely, dermatomyositis, progressive systemic scleroderma, and systemic lupus erythematosus. In two patients the symptoms of disease overlapped. The rare anti-Ku antibody was found in all of them. Anti-Ku antibody characterizes those patients, with polymyositis-scleroderma overlap syndromes who have a good prognosis. One of our patients, who also had severe anti-Sm-positive systemic lupus erythematosus, seems to be an exception.
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A patient with photosensitivity is described who presented with an overlap syndrome combining features of systemic lupus erythematosus with a mild polymyositis and scleroderma and with symptoms of the sicca syndrome. In addition, he was anti-SSA/Ro positive and had a constellation of antibodies directed to ENA including the anti-SL-Ki antibody. The condition was fatal and he died from heart failure and respiratory insufficiency.