Biomedical subjects
Publications and source records attributed to A Woscoff.
A 23 year-old woman with sarcoidosis initiated her illness with painful nodules located in palms and soles. This is un unusual clinical finding. Sarcoidosis must be included in the differential diagnosis of painful palmoplantar nodules.
Three members of one family with keratoderma Thost-Unna and histopathological picture of epidermolytic hyperkeratosis are reported. Several dermatoses with this abnormality of the keratinization are mentioned and the literature cases with keratoderma are reviewed. The treatment with oral aromatic retinoid though improved the hyperkeratosis, had to be discontinued because the vulnerability of the newly skin. Exhibited erosions with the consequent discomfort. The association of keratoderma with epidermolytic hyperkeratosis would be more frequently observed if the histopathological examination were performed in all cases.
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Dystrophic epidermolysis bullosa has a rare recessive polydysplastic vegetant variant, which was described by Nicolas et al. Two siblings are reported. The male was affected by urethral lesions, an exceptional finding in this disease. Many members in family died of renal insufficiency . A variety of therapeutics was indicated along ten years. Only hydantoins caused a marked involution of the lesions. An interesting feature was that high drug levels in the blood produced not only common side effects, such as macrulia , but also exacerbation of the dermatosis and growth of new lesions, which took on a botriomicoid aspect.
A new case of diffuse melanosis with melanuria is reported. Light and electron microscopic technics were employed. Several hypothesis were proposed to explain the pathogenesis of this particular pigmentation: Dermal perivascular histiocitic cells phagocyte organelles originated in lysed circulating melanoma cells. Phagocytosis of the altered circulating melanoma cells by the endothelium. Macrophages containing ingested melanin migrate from the capillary lumen into the dermis. We consider that in this particular pigmentation participate two mechanism: a) The perivascular dermal macrophage phagocyte the pigment originated in the lysis of the circulating melanoma cells. b) Macrophages loaded with pigment granules cross the capillary wall and remain around the blood vessels.
The results of this open multicenter trial with 100 patients of both sexes show that a single 300-mg dose of rosoxacin (Win 35,213) was effective in achieving a 94% cure rate, both clinical and bacteriological, on the seventh day after treatment in patients with uncomplicated acute gonococcal infection. The cure rate in men was 94% (86/92) and in women 100% (8/8). All isolates of Neisseria gonorrhoeae were susceptible to rosoxacin, as determined by 5-micrograms sensitivity disks. Adverse effects were seen in 14 patients--13 men and one woman. Twelve patients reported dizziness, one drowsiness, and one visual changes. It is concluded that rosoxacin can be of great usefulness in the epidemiological control of acute gonococcal infection, because of the lack of in vitro resistance to it, its minimal adverse effects, the low dose requirements, and the effectiveness of a single dose. The drug does not appear to have any treponemicidal action.
Thirty-six patients were treated for single or multiple warts by intralesional injection of bleomycin sulfate (Blenoxane) at the base of the wart. The dose varied according to the size of the lesion and ranged from 0.2 to 0.8 mg per injection, up to a maximum total dose of 2 mg. The cure rates were as follows: 67 percent in plantar warts; 82 percent in ungual warts; and 80 percent in warts located elsewhere. The cure rate for all patients was 75 percent. The drug was well tolerated and the procedure readily accepted by the patients.
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Several closely related conditions make up the idopathic hypereosinophilic syndrome. This syndrome is characterized by persistent and prolonged eosinophilia. The most frequent lesions are in the hematologic, neurologic and gastrointestinal systems. A case is reported in which the initial complaint was an erythema annulare centrifugum.
Two personal cases of Non venereal Lymphangitis of the Penis are presented in 23 and 28 men, and 38 cases from the literature are reviewed. This benign self-limiting condition is not too well known among dermatologists and urologists. The clinical changes, in particular noted by palpation are characteristic: painless firm cartilaginous cord freely movable behind the corona of glans penis in the coronary sulcus. The inguinal lymph nodes are not involved. The microscopic features in one of our patients demonstrated that the lesion results from cystic dilatation of secondary organization of the thrombus. The etiology is unknown. We favour the mecanical trauma as an important factor based on excessive sexual activity of the patients.
In severe forms of acne (grade IV) there is probably an inmunological alteration consisting of: 1) Alterations in the IgG. 2) They may be produced in small quantity or destroyed more rapidly. 3) Cellular immunity is normal using PHA and diminished with habitual tests. 4) It is necessary to normalize these globulin levels before or during specific medication, with antibiotics or sulfa drugs. 5) Essential aminoacids should be given so as to raise the inmunoglobulins to normal levels. The administration of commercial inmunoglobulins should be avoided, because, for genetic reason, they could produce autoimmunity or isosensibility and diminished the levels one is trying to raise.
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