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C J Cockerell

Publications and source records attributed to C J Cockerell.

At least 91 records · Page 5Linked to original sources
PubMed1994

Persistent indurated plaques of the face: a variant of Jessner's lymphocytic infiltrate?

Lymphocytic infiltrates of the skin classically include a select number of diagnostic entities such as lupus erythematosus, gyrate erythema, polymorphous light eruption, lymphocytoma cutis, lymphocytic leukemia, and lymphocytic infiltrate of Jessner. We recently observed two patients with chronic inflammatory plaques of the face with histologic features of a lymphocytic infiltrate with unusual clinical features. Persistent indurated plaques of the face may be a manifestation of lymphocytic infiltration of the skin that could represent a variant of Jessner's lymphocytic infiltrate. Cases may be refractory to all forms of treatment other than systemic corticosteroids. Clinicians should be aware of this variant and exclude lupus erythematosus and photodermatitis.

Adult↗
PubMed1993

Early oral presentation of lues maligna in a patient with HIV infection. A case report.

We present a case of a patient infected with the human immunodeficiency virus who developed syphilis manifested by atypical early oral and skin ulcerations. The profound immune defects associated with human immunodeficiency virus may lead to an altered clinical presentation and a more aggressive course in patients infected with Treponema pallidum. The unusual clinical manifestations observed in this case emphasize the importance of considering secondary syphilis in the differential diagnosis of any inflammatory mucosal and skin disorder in patients with the human immunodeficiency virus.

AIDS-Related Opportunistic Infections↗
PubMed1993

Allergic contact dermatitis from color film developers: clinical and histologic features.

We evaluated two patients with allergic contact dermatitis that resulted from exposure to color film developers. A lichenoid eruption developed in one patient, whereas an eruption more characteristic of an acute spongiotic dermatitis developed in the second patient. Histologic findings in the first case were those of a "lichenoid dermatitis" but with features distinct from classic lichen planus. The biopsy specimens from the second patient showed a subacute spongiotic process with a bandlike infiltrate suggestive of an evolving lichenoid process. Contact allergy to color developers may result in eruptions similar to lichen planus. This process appears to evolve from an acute spongiotic dermatitis in its early phase to a lichenoid dermatitis in fully developed and more chronic forms. Although the histologic features are those of a "lichenoid" dermatitis, some features, such as the presence of spongiosis, eosinophils, and a less intense inflammatory infiltrate, may enable distinction between lichenoid allergic contact dermatitis and true lichen planus. In addition, clinicopathologic correlation with patch test results should permit accurate diagnosis in most cases.

Adult↗
PubMed1993

Nodular lesions of erythema elevatum diutinum in patients infected with the human immunodeficiency virus.

BACKGROUND: Erythema elevatum diutinum (EED) is a rare, chronic form of cutaneous vasculitis that can result in fibrosis. Four patients infected with the human immunodeficiency virus (HIV) had unusual nodular lesions of EED. OBJECTIVE: Our purpose was to document the occurrence of these lesions in HIV-infected patients and to characterize the histopathologic and immunophenotypic features of nodular EED. METHODS: Clinicopathologic studies were supplemented by special stains of biopsy specimens. RESULTS: EED may be a complication of HIV infection. Nodules of EED are composed of small aggregates of Mac-387+ spindled cells. Within the aggregates can be seen neutrophils, nuclear dust, and fibrin. The marked fibrosis of the lesions may account for the lack of response to dapsone. CONCLUSION: EED should be considered in the differential diagnosis of juxta-articular nodules in HIV-infected patients; its diagnosis can be confirmed by biopsy.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Concomitant psoriasis, seborrheic dermatitis, and disseminated cutaneous histoplasmosis in a patient infected with human immunodeficiency virus.

Cutaneous involvement with disseminated histoplasmosis occasionally occurs in patients infected with the human immunodeficiency virus. We describe a profoundly immunocompromised patient with acquired immunodeficiency syndrome who had concomitant psoriasis, seborrheic dermatitis, and disseminated histoplasmosis, each with similar features. Findings of a skin biopsy specimen from a lesion on the forehead showed an infiltrate of histiocytes filled with Histoplasma capsulatum. In disseminated histoplasmosis involving the skin, lesions may have features more characteristic of a papulosquamous dermatosis than an infectious disease. In patients infected with human immunodeficiency virus, especially those with low numbers of CD4+ cells, serious infectious diseases may have unusual features and may assume the appearance of concomitant inflammatory diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Disseminated epidermolytic acanthoma.

A 57-year-old man developed hundreds of light brown, slightly atrophic papules, which were distributed diffusely over the back. Although clinically the lesions resembled seborrheic keratoses, histologic examination demonstrated changes of epidermolytic hyperkeratosis. The patient had neither a personal nor a family history of ichthyosiform disorders. The diagnosis of disseminated epidermolytic acanthoma was made in the context of the clinical, histologic, and historical features. Disseminated epidermolytic acanthoma is a rare condition that is readily diagnosable using clinicopathologic correlation; it is important to exclude it from other more serious conditions associated with epidermolytic hyperkeratosis.

Humans↗
PubMed1993

Think melanoma.

Every physician's office should be a melanoma detection station. Identification and surgical excision of early melanoma is today's best answer to reducing the death rate from this treacherous disease. Public awareness of melanoma is gaining momentum. Melanoma education for physicians is vital if the battle against melanoma is to be successful. This presentation is a challenge to all physicians and students of medicine to identify patients at risk for melanoma and to follow up with a skin scan to search for suspicious spots on all patients with risk factors for melanoma as a part of their physical examination. We need to teach individuals at risk to do self-examination, to report immediately any recent growth changes in an existing mole or any recently acquired pigmented lesion, and to practice the rules of safe sun exposure. Because securing a suitable specimen of tissue for biopsy and proper interpretation of sections are paramount in patient management and understanding prognosis, we present guidelines for performing a proper biopsy.

Biopsy↗
PubMed1993

Hemangioma-associated rhinophyma. Report of a case with successful treatment using carbon dioxide laser surgery.

BACKGROUND: Rosacea is a disorder characterized by erythematous papules, pustules, and telangiectases involving the nose, chin, cheeks, and forehead that may progress to rhinophyma. Although the etiology of rosacea remains unclear, a common theme in pathogenesis is vasodilation. Rosacea has been associated with both idiopathic flushing as well as that induced secondarily. OBJECTIVE: To report clinical and histologic features of rhinophyma that developed in association with a longstanding cavernous hemangioma. RESULT: The patient is a 57-year-old Hispanic man with a congenital port-wine stain that had developed into a nodular, cavernous hemangioma over the course of years. Clinically, in the site of the angioma there was marked soft-tissue overgrowth with sebaceous hyperplasia. These changes were confined to the angiomatosis areas and were sharply demarcated from the surrounding normal skin. Histologically, there was marked fibroplasia; numerous small cysts, some with focal rupture and inflammation; dilated follicular ostia; and prominent sebaceous gland hyperplasia in addition to numerous ectatic blood vessels, which were a component of the hemangioma. In contrast, normal-appearing skin adjacent to this site revealed only normal sebaceous glands and no fibroplasia. Treatment consisted of CO2 laser excision of the nodular components of the hemangioma with a tightly focused beam, followed by resculpting of the natural facial contour with laser abrasion of hypertrophic soft tissues with a broad, unfocused beam. The treated area healed well, with a skin tone of a more natural color than the original hemangioma. CONCLUSION: Our findings suggest that rhinophyma may develop secondary to the vasodilation seen in large hemangiomas and that the CO2 laser offers excellent treatment for both the vascular and stromal components of the lesion.

Hemangioma, Cavernous↗
PubMed1993

Atypical fibroxanthoma: DNA ploidy analysis of 14 cases with possible histogenetic implications.

The histogenesis of atypical fibroxanthoma (AFX) and its relationship to malignant fibrous histiocytoma (MFH) are a subject of controversy. Many investigators have proposed that AFX may represent a reactive process, while others contend that it is a true fibrohistiocytic neoplasm, closely related to MFH. In an attempt to determine whether biologic differences between AFX and MFH may be accounted for at the cellular DNA level, we performed ploidy analysis on 14 cases of AFX by flow cytometry and compared our results with previously reported DNA analyses of MFH. Thirteen of the 14 lesions demonstrated diploid distribution of nuclear DNA, and only 1 case had an aneuploid population. This contrasts with prior data on MFH, the vast majority of which are aneuploid. Our results suggest that, despite histologic similarities, AFX may be distinguished from MFH on the basis of DNA content. These findings may be significant in understanding the biologic behavior of AFX.

DNA, Neoplasm↗
PubMed1992

Widespread cutaneous and systemic calcification (calciphylaxis) in patients with the acquired immunodeficiency syndrome and renal disease.

BACKGROUND: Calciphylaxis is a form of widespread calcification that may occur in patients with renal disease and hyperparathyroidism. The skin is often affected secondary to vascular compromise and ischemia. Patients infected with the human immunodeficiency virus (HIV) are predisposed to renal failure and thus may develop this serious complication. OBJECTIVE: The purpose of this article is to describe two cases of fatal calciphylaxis in patients with the acquired immunodeficiency syndrome and renal disease. METHODS: Two patients were examined clinically and through the performance of serologic studies and skin biopsies. RESULTS: Both patients had a widespread livedo reticularis-like eruption, which rapidly progressed to cutaneous gangrene. Patient 1 had elevated serum calcium and phosphorus levels whereas patient 2 had normal values but had markedly elevated serum parathyroid hormone levels. Biopsy specimens in both cases showed vascular thrombosis and soft tissue calcification. CONCLUSION: Widespread calcification may develop in patients with HIV infection and renal failure and, in some cases, calcium and phosphorus levels may be normal.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The clinical spectrum of bacillary angiomatosis.

Bacillary angiomatosis is a recently recognized bacterial infectious disease that is seen mainly in patients with the acquired immunodeficiency syndrome. Including this publication, 45 patients have been described in the medical literature. In this report we describe examples of the clinical presentations of bacillary angiomatosis and review therapeutic strategies.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Pityriasis rubra pilaris in the setting of HIV infection: clinical behaviour and association with explosive cystic acne.

The development of pityriasis rubra pilaris (PRP) in three patients with human immunodeficiency virus (HIV) infection is described. Two of the patients had onset of severe generalized cystic acne concomitant with their development of PRP. PRP and acne conglobata should be added to the group of cutaneous disorders that can present in a more virulent manner in the setting of HIV infection. The association of cystic acne with PRP and their response to treatment are discussed.

Acne Vulgaris↗
PubMed1992

Sensitivity of diagnosis of malignant melanoma: a clinicopathologic study with a critical assessment of biopsy techniques.

Although most examples of cutaneous malignant melanoma are easily recognized by their clinical appearances, in some cases this serious neoplasm may clinically simulate other less serious forms of skin cancer or benign processes. This study was undertaken to assess both the sensitivity of clinical diagnosis of cutaneous malignant melanoma and the efficacy of biopsies of clinically unsuspected melanomas in yielding specimens on which complete and accurate histologic assessments could be made. A retrospective analysis of 1784 cases of histologically proven melanomas diagnosed between 1985 and 1990 was performed in search of lesions not clinically suspected. Biopsy techniques used to sample these lesions were subjected to critique of their efficacy in yielding specimens that could be accurately diagnosed and completely assessed histologically. Of 1784 histologically proven primary cutaneous melanomas, 583 were not clinically suspected, yielding a sensitivity of 67%. Clinical diagnosis included nevi (33%), no diagnosis (17%), multiple diagnoses (13%), basal cell carcinoma (12%), keratosis (9%), and lentigo (9%) among others. The biopsy methods used to sample these lesions were shave (56%), excisional (24%), punch (11%), curettage (2%), and undetermined (6%). Eighty-six percent of shave biopsies could be accurately assessed while only 32% of punches and no curettages provided sufficient material for both definitive and complete evaluation of melanomas. Eighteen percent of specimens histologically reviewed were considered inadequate for complete evaluation. In 34%, the actual diagnosis of melanoma was uncertain because of inability to assess diagnostic features as a consequence of the biopsy technique. Melanoma may be unsuspected clinically in a significant number of cases and may be mistaken for less serious cutaneous neoplasms.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗