Environmental factors influencing rosacea.
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Adult↗
Biomedical subjects
C M Mills
Publications and source records attributed to C M Mills.
Posterior crossbites in children.
Posterior crossbite, the most common malocclusion in young children, can be caused by a variety of skeletal, muscular, or dental factors. This condition produces insufficient maxillary arch width and is frequently associated with various oral sucking and postural habits. If left untreated, this problem can result in adverse skeletal growth changes. Various mechanical treatment modalities designed to expand the posterior maxillary arch width are available to correct this problem. The appropriate treatment method depends on the patient's age and level of cooperation as well as the determined etiology of the constriction.
Child↗
Cutaneous infection with Tunga penetrans.
A 23-year-old man presented with a small black lesion at the distal margin of the right great toenail. He had returned from the Ivory Coast 1 month previously, having spent 6 weeks there. Histopathological examination of material extruded from the lesion showed a variety of arthropod internal organs, allowing a definitive diagnosis of infection with the ectoparasitic flea Tunga penetrans. Curettage of the lesion revealed a gravid adult female flea.
Adult↗
Tinea capitis in south Wales--observations in change of causative fungi.
We report an observed change in the causative organisms in 45 consecutive cases of tinea capitis seen in the Cardiff area over the last 9 years. Direct microscopy using potassium hydroxide was positive in all but one case, but this was subsequently positive on culture. This retrospective analysis shows that more cases are being seen in our department, and that a higher proportion of cases are due to Trichophyton violaceum whereas previously we would have expected the majority of cases to be due to Microsporum canis. We believe that the change in causative organism that we have identified has important practical and diagnostic implications. Endothrix fungi such as T. violaceum do not fluoresce under Wood's lamp unlike ectothrix fungi such as M. canis, and therefore failure to perform adequate mycological examination of specimens could result in missed diagnoses. We are not aware of this change having been reported from other UK centres. The finding indicates a need for further prospective epidemiological studies to confirm this apparent trend.
Child↗
Cigarette smoking is not a risk factor in atopic dermatitis.
BACKGROUND: In recent years several diseases have been shown to have a relationship with smoking. Psoriasis is largely a disease of smokers, whereas acne appears to be associated with not smoking. METHODS: One hundred and fifty patients with atopic dermatitis were sent a postal questionnaire on smoking habits and the results were compared with those from matched controls in the local community. RESULTS: One hundred and twenty-seven patients (85%) completed the questionnaire. There was no apparent difference in the prevalence of current smokers amongst atopic dermatitis patients compared with controls (odds ratio = 1.1, 95% confidence limits 0.65-1.86, P = 0.8). CONCLUSIONS: There was no significant difference between the smoking prevalence of patients with atopic dermatitis and matched controls.
Dermatitis, Atopic↗
Altered inflammatory responses in smokers.
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Humans↗
Acral epidermolytic hyperkeratosis.
We present a family with a distinctive pattern of epidermolytic hyperkeratosis which is mild, restricted to the distal parts of the limbs, and non-disabling. Features of the other variants of epidermolytic hyperkeratosis are discussed.
Child↗
Does smoking influence acne?
One hundred and sixty-five patients with acne completed a questionnaire on smoking habits. Amongst 96 males, 19.7% were smokers (95% confidence interval 12.4-29.2%) compared to an expected prevalence of 34.5% from national statistics (P < 0.001). For 69 females, a prevalence of 12.1% (95% confidence interval 6.1-23.3%) was obtained compared to 32.7% expected (P < 0.001). The findings of this study support the hypothesis that some component of cigarette smoke, possibly nicotine, has an anti-inflammatory action on acne.
Acne Vulgaris↗
Cutaneous calcinosis--an unusual complication of intravenous phosphate administration.
The case of an 80-year-old woman who developed extensive cutaneous calcification following intravenous phosphate administration is presented. Also the circumstances under which cutaneous calcification may occur are discussed.
Aged↗
Side effects of topical glucocorticoids.
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Administration, Cutaneous↗
Adverse reactions to oral retinoids. An update.
Retinoids, both naturally occurring and synthetic, are analogues of vitamin A. They represent a major advance in the treatment of acne and psoriasis, as well as rarer conditions such as the ichthyoses. The more frequent and widespread use of these drugs requires that the dermatologist be aware of the wide spectrum of adverse events that may be encountered with their use. Some are serious and irreversible, such as teratogenicity, necessitating great care if these drugs are given to women of childbearing potential. Other effects may be less severe, dose dependent and reversible. Although not devastating to the patient, appropriate advice may reduce morbidity.
Administration, Oral↗
A pharmacokinetic study of sulphasalazine and two new formulations of mesalazine.
We have examined the pharmacokinetics of enteric coated sulphasalazine compared with two new formulations of mesalazine. These consisted of microgranules of mesalazine coated with Eudragit S in a concentration of either 20 or 25% dry lacquer substance; these in turn were enclosed in capsules coated with Eudragit L. In-vitro dissolution studies of coated microgranules showed that drug release was pH dependent. Studies in 7 normal volunteers showed median peak concentrations of 5-amino-salicylic acid and N-acetyl-5-amino-salicylic acid occurred at about 6 hours with both microgranular preparations, compared with sulphasalazine at 15 h. The microgranule formulation coated with 20% Eudragit S gave serum levels and overall systemic absorption similar to values with sulphasalazine. This new formulation may be of value for delivering mesalazine and other therapeutic agents to the colon.
Adult↗
Smoking habits in psoriasis: a case control study.
We have examined smoking habits in 108 patients with psoriasis, including some with palmoplantar distribution, and compared the results with matched controls from the community. There was a significant association between psoriasis, current smoking status (OR = 2.7, 95% CI 1.44-5.42, P less than 0.01) and smoking habits prior to the onset of disease (OR = 3.75, 95% CI 1.68-9.47, P less than 0.001). There was also a marked dose-response relationship; the relative risk of psoriasis in those currently smoking more than 20 cigarettes/day was significantly elevated (OR = 5.3, 95% CI 2.1-13.0, P less than 0.001). Separate analysis of patients without palmoplantar distribution of psoriasis showed a significant association with smoking prior to onset of psoriasis (OR = 3.6, 95% CI 1.5-9.8, P less than 0.001). Smoking may play a role in the aetiology of this common skin disorder.
Adolescent↗
Accuracy of Borg's ratings of perceived exertion in the prediction of heart rates during pregnancy.
When using Borg's 6-20 scale during pregnancy, ratings of perceived exertion (RPE) did not significantly correlate with exercise heart rates (HR) (P greater than 0.05). The HR predicted from RPE significantly (P less than 0.05) underestimated the exercise HR in the second trimester during walking (Group 1: mean difference 16 beats min-1, n = 11), aerobics classes (Group 4: mean 15 beats min-1, n = 48) and circuit training (Group 3: mean 18 beats min-1, n = 24); and in the third trimester during cycling (Group 2: mean 16 beats min-1, n = 12) and aerobics classes (Group 5: mean 11 beats min-1, n = 29). Maximal individual HR under-estimations were large for each physical activity during pregnancy, with values up to 54 beats min-1. Consequently, exercise intensity should not be monitored solely with RPE during pregnancy.
Exercise Test↗
Osteolytic lesions and bacillary angiomatosis in HIV infection: radiologic differentiation from AIDS-related Kaposi sarcoma.
Bacillary angiomatosis is a newly recognized multisystem bacterial infectious disease seen in the setting of human immunodeficiency virus (HIV) infection. The disease is marked by cutaneous vascular lesions that contain a bacterium similar to the cat scratch disease bacillus. Antibiotic therapy leads to the resolution of both cutaneous and systemic manifestations. Of 17 HIV-infected patients with cutaneous lesions of bacillary angiomatosis, six (35%) had symptomatic osteolytic bone lesions that improved following antibiotic therapy. The authors describe the appearance of the bone lesions on radiographs, computed tomographic (CT) scans, magnetic resonance (MR) images, and radionuclide studies. Osteolytic lesions are a relatively common feature of bacillary angiomatosis in patients with HIV infection. The presence of bone lesions aids in differentiation of bacillary angiomatosis from acquired immunodeficiency syndrome-related Kaposi sarcoma, which has similar cutaneous abnormalities but no associated bone lesions.
Acquired Immunodeficiency Syndrome↗
The efficacy and clinical impact of brain imaging in neurologically symptomatic AIDS patients: a prospective CT/MRI study.
The relative efficacies of cranial magnetic resonance imaging (MRI) and computed tomography (CT) brain scans for the detection of intracranial pathology in patients with the acquired immune deficiency syndrome (AIDS) were evaluated prospectively. Fifty homosexual or bisexual men with AIDS and neurologic symptoms were evaluated using both modalities. In 24 patients, MR images and CT scans provided the same diagnostic information (within normal limits in 16, cerebral atrophy only in 6, and similar lesions in 2 patients). In only one instance did CT show the presence of a lesion not seen on MRI. In the 25 remaining patients, MRI was the more sensitive modality. MRI also reflected more consistently the histopathologically documented extent and distribution of central nervous system disease. The greater sensitivity of MRI suggested significant alterations in the diagnostic evaluation and therapeutic management of 20 patients. Thus, MRI was as good or better than CT for the detection of intracranial pathology in 49 of 50 neurologically symptomatic AIDS patients and significantly affected the diagnosis and treatment of 40% of these patients. Although MRI does not appear to be more specific than other modalities in the differentiation of human immunodeficiency virus (HIV)-related neurologic diseases, its greater sensitivity suggests that MRI may be the best neuroimaging procedure for the initial radiologic evaluation of AIDS patients with neurologic illness.
Acquired Immunodeficiency Syndrome↗
MRI of the knee in diffuse pigmented villonodular synovitis.
Magnetic resonance imaging (MRI) was performed on 11 patients with surgically proven pigmented villonodular synovitis (PVNS) of the knee. PVNS was diagnosed on the basis of presence of hemosiderin, joint effusion, and hyperplastic synovium without significant joint destruction. MRI provided a detailed map of the distribution of the disease within the joint, emphasizing the common occurrence of the disease behind the cruciate ligaments and in synovial cysts in the popliteal fossa. MRI aided in preoperative planning and postoperative follow-up for residual and recurrent disease. Nine additional cases of joint hemorrhage, hemophilia, desmoplastic tumors, and synovial chondromatosis were included to delineate differential diagnostic criteria.
Adult↗