Biomedical subjects
Publications and source records attributed to B K Fisher.
Granuloma inguinale (GI) is a sexually transmitted disease seldom seen in the United States and Canada. We are reporting three cases recently seen in Toronto, Ontario, two in immigrants, and one in a native born Canadian who had an intimate relationship with a foreign visitor. The basic features of the disease are discussed.
A 78-year-old man presented simultaneously with subacute cutaneous lupus erythematosus (SCLE) and Sweet syndrome (neutrophilic dermatosis). He was subsequently investigated for and found to have Sjögren syndrome. We believe that the simultaneous occurrence of the above cutaneous manifestations are very suggestive of and should prompt investigation for Sjögren syndrome.
We report the first case of acral localized acquired cutis laxa. The skin laxity was preceded by swelling of the fingers and toes and by the appearance of papular urticaria. Dapsone therapy was effective in controlling the swelling. Examination of skin biopsy specimens showed fragmentation and almost total loss of elastic fibers in the areas of cutis laxa. Electron microscopy showed no abnormalities in elastic structure and function in unaffected skin. In addition, electron microscopic examination of an urticarial lesion showed a neutrophilic dermatosis with polymorphonuclear leukocytes attached to the surface of either normal elastic fibers or fibers showing early degenerative changes. These findings suggest that there is no primary defect in the elastic fibers and that the polymorphonuclear leukocytes play a significant role in the destruction of the elastic fibers and the subsequent development of cutis laxa in this case.
A case of tuberculous skin ulcer is reported. The biopsy specimen did not reveal acid-fast bacteria but cultures grew Mycobacterium tuberculosis. A high index of suspicion is needed to diagnose mycobacterial ulcers correctly. The classification of the cutaneous tuberculoses is discussed.
Explore the source record for details and available documents.
We describe the clinical and pathologic observations of a 45-year-old woman with linear porokeratosis who developed squamous cell carcinoma in lesional sites. The squamous cell carcinoma metastasized to a regional lymph node. This is the second case of metastatic squamous cell carcinoma reported in porokeratosis and the first reported in the linear variety.
Explore the source record for details and available documents.
A case is presented of an epidermoid cyst on the sole of the foot. Although few dermatologists have ever encountered this entity, a number of cases have been reported in the podiatric literature. Careful clinical examination should lead to the recognition of more of these lesions, which are easily confused with warts and calluses.
Explore the source record for details and available documents.
Immunohistochemical staining of tuberculoid and lepromatous leprosy skin lesions was performed using various rabbit antisera. Macrophages in both stained with serum containing antibodies against lysozyme and alpha-1-antitrypsin, while macrophages in lepromatous leprosy also reacted with other antibodies. An immunoglobulin fraction of positive serum stained following pepsin digestion, indicating that reactivity was not Fc dependent. Positive serum contained antibody against Mycobacterium butyricum, which caused macrophage staining, since affinity-purified antibody did not stain and absorption with M. butyricum removed staining. Staining was also produced by serum of subjects with leprosy or a positive tuberculin test. By immunoblotting, the anti-mycobacterial antibody was directed against surface components of M. butyricum of molecular weights 20 000-70 000. Electron microscopy showed M. leprae in phagolysosomes of macrophages, while immunoelectron microscopy demonstrated labelling along bacterial cell membranes. Therefore, macrophages in lepromatous leprosy skin lesions stain because they contain M. leprae, which reacts with antibody to either M. leprae, M. tuberculosis or atypical mycobacteria in human serum and with antibody to M. butyricum in serum from rabbits immunized with various antigens and Freund's complete adjuvant. These results indicate that immunohistochemical studies on leprosy are misleading if performed using intact polyclonal immune sera rather than affinity purified or monoclonal antibodies.
Ganglia rarely occur on the ankle. We report a case of a ganglion on the medial malleolus, originating from the sheaths of the flexor digitorum longus and tibialis posterior tendons, which posed a diagnostic dilemma for the patient's family physician, for her dermatologist, and for the orthopedic surgeon seen in consultation. Ganglia should be considered in the differential diagnosis of all periarticular cystic lesions.
Woringer-Kolopp disease usually manifests as a solitary cutaneous patch or several patches confined to a single body region. While most cases have a good prognosis, there have been rare reports of cases with an aggressive course and a fatal outcome. The authors present two women who are alive with this condition, which, they believe is a variant of mycosis fungoides.
Explore the source record for details and available documents.
A case of eccrine spiradenoma (ESA) is described in a 35-year-old man. During an 18-year period, the original number of tumors grew in size and fused into large groups. Surgical excision of all tumors was performed successfully. The unusual features of the case were a linear distribution and giant multifocal tumors. The histology of the tumors and their appearance at the beginning and 18 years later is described.
Two cases of leishmaniasis recidivans of twenty years' duration were treated intravenously with sodium stibogluconate (Pentostam) with good results. Before treatment, histologic examination of a biopsy specimen revealed many Leishman-Donovan (LD) bodies. After treatment, repeated biopsies done in one of the cases revealed only scar tissue. We recommended treatment with sodium stibogluconate in cases of leishmaniasis recidivans, although an ideal treatment for this condition still does not exist.