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Biomedical subjects

D F Mutasim

Publications and source records attributed to D F Mutasim.

At least 37 records · Page 2Linked to original sources
PubMed1999

Steatocystoma multiplex: a quick removal technique.

A 27-year-old man with multiple lesions located on his chest and neck and diagnosed as steatocystoma multiplex desired removal of these lesions. We report a facile, fast, and successful technique for the removal of lesions of steatocystoma multiplex. Using a no. 11 blade, we incised the domes of numerous lesions and removed the cyst walls with small artery forceps. Within 1 month, the incisions healed without scarring, and after 4 months of follow-up, they had not recurred. This procedure allows the removal of many lesions of steatocystoma in a few office visits.

Adult↗
PubMed1999

Autoimmune bullous diseases: diagnosis and management.

Bullous diseases constitute a wide group of disorders in which blistering of the skin and/or mucous membranes occurs. Patients may develop other lesions in addition to blisters. It is important for dermatology nurses to understand the pathogenesis of these disorders, the means for making an accurate diagnosis, and systemic and local management of the diseases.

Anti-Inflammatory Agents↗
PubMed1999

Bowel bypass syndrome without bowel bypass.

"Bowel bypass syndrome without bowel bypass" is an entity in which patients have the same clinical presentation as patients with bowel bypass syndrome, but with other gastrointestinal disorders. We present two cases of this disorder, one who responded to metronidazole and ciprofloxacin, and the other who responded to prednisone and metronidazole.

Adult↗
PubMed1998

Cutaneous pseudolymphomas.

Cutaneous pseudolymphoma refers to a heterogeneous group of benign reactive T- or B-cell lymphoproliferative processes of diverse causes that simulate cutaneous lymphomas clinically and/or histologically. The inflammatory infiltrate is bandlike, nodular, or diffuse and is composed predominantly of lymphocytes with or without other inflammatory cells. Depending on the predominant cell type in the infiltrate, cutaneous pseudolymphomas are divided into T- and B-cell pseudolymphomas. Cutaneous T-cell pseudolymphomas include idiopathic cutaneous T-cell pseudolymphoma, lymphomatoid drug reactions, lymphomatoid contact dermatitis, persistent nodular arthropod-bite reactions, nodular scabies, actinic reticuloid, and lymphomatoid papulosis. Cutaneous B-cell pseudolymphomas include idiopathic lymphocytoma cutis, borrelial lymphocytoma cutis, tattoo-induced lymphocytoma cutis, post-zoster scar lymphocytoma cutis, and some persistent nodular arthropod-bite reactions. This review attempts to discuss current aspects of the classification, pathogenesis, clinical spectrum, histopathologic and immunohistochemical diagnosis, and laboratory investigations for clonality in the various types of cutaneous pseudolymphomas.

Diagnosis, Differential↗
PubMed1998

Characteristics of 34 adults with psychogenic excoriation.

BACKGROUND: Psychogenic excoriation, characterized by excessive scratching or picking of the skin, is not yet recognized as a symptom of a distinct DSM-IV disorder. The purpose of this study was to provide data regarding the demographics, phenomenology, course of illness, associated psychiatric comorbidity, and family history of subjects with psychogenic excoriation. METHOD: Thirty-four consecutive subjects were recruited from an outpatient dermatology practice and by advertisement. Subjects completed the Structured Clinical Interview for DSM-IV augmented with impulse control disorder modules, the Yale-Brown Obsessive Compulsive Scale, and a semistructured interview for family history, demographic data, and clinical features. RESULTS: Most subjects were women who described a mean age at onset of 38 years and a chronic course. Subjects excoriated multiple sites, most frequently the face. The behavior caused substantial distress and dysfunction. All 34 subjects met criteria for at least 1 comorbid psychiatric disorder, with a mood disorder the most common. Family histories were notable for depressive disorders and psychoactive substance use disorders. Most subjects experienced both mounting tension before excoriation and relief after excoriation as in impulse control disorders. A minority of subjects excoriated skin as part of obsessive-compulsive disorder. Body dysmorphic disorder with preoccupation about the skin's appearance precipitated excoriation in about a third of subjects. CONCLUSION: Psychogenic excoriation is chronic, involves multiple sites, and is associated with a high rate of psychiatric comorbidity. The behavior associated with the excoriation is heterogeneous and spans a compulsive-impulsive spectrum. Most subjects in this sample described features of an impulse control disorder.

Adult↗
PubMed1997

Follicular psoriasis: an under-reported entity. A report of five cases.

Follicular psoriasis is not rare in dermatological practice, although only a few cases have been reported. We describe five patients with follicular psoriasis, one man and four women. The patients ranged in age from 23 to 73 years. Lesions consisted of erythematous scaly follicular papules located on the trunk and extremities. Two patients had associated plaque-type psoriasis of the scalp. None had nail involvement at the time of diagnosis. Histological examination of several biopsy specimens revealed the changes of psoriasis in the follicular epithelium.

Adult↗
PubMed1996

Herpes simplex virus infection masquerading as condyloma acuminata in a patient with HIV disease.

Verrucous lesions in patients with human immunodeficiency virus (HIV) disease may be caused by viruses other than the human papillomavirus. We describe a 32-year-old HIV-positive black man who presented with a verrucous lesion of the intergluteal cleft that clinically resembled condyloma acuminata or verrucous carcinoma. Histopathological examination revealed the changes of herpes virus infection, and culture of the tissue confirmed the presence of herpes simplex virus. Human papillomavirus was not detected by in situ hybridization or the polymerase chain reaction. Significant regression of the lesion was seen after 6 weeks of treatment with oral acyclovir.

AIDS-Related Opportunistic Infections↗
PubMed1995

Pyostomatitis vegetans associated with ulcerative colitis. Temporary clearance with fluocinonide gel and complete remission after colectomy.

Pyostomatitis vegetans is a rare condition characterized by pustules that affect the oral mucosa. It is consistently associated with inflammatory bowel disease and is usually resistant to treatment. We present the case of a 65-year-old white man with pyostomatitis vegetans that was associated with ulcerative colitis and adenocarcinoma of the colon. Fluocinonide gel resulted in a complete but temporary clearance of the lesions. Complete remission was achieved immediately after a total colectomy.

Adenocarcinoma↗
PubMed1993

Skin explant culture: a reliable method for detecting pemphigoid antibodies in pemphigoid sera that are negative by standard immunofluorescence and immunoblotting.

We investigated the presence of bullous pemphigoid antibodies in bullous pemphigoid sera that are negative by standard indirect immunofluorescence. We incubated each of four indirect immunofluorescence-positive bullous pemphigoid sera, seven indirect immunofluorescence-negative bullous pemphigoid sera, one indirect immunofluorescence-negative herpes gestationis serum, three indirect immunofluorescence-positive epidermolysis bullosa acquisita sera, five indirect immunofluorescence-negative epidermolysis bullosa acquisita sera, and two normal human sera with fresh human skin explants in medium 199 at 4 degrees C for 48 h. All bullous pemphigoid sera, herpes gestations serum, and the three indirect immunofluorescence-positive epidermolysis bullosa acquisita sera had IgG that bound the basement membrane zone of skin explants with moderate to marked intensity as demonstrated by immunofluorescence. Normal sera and indirect immunofluorescence-negative epidermolysis bullosa acquisita sera failed to bind the explant basement membrane zone. Immunoblotting of bullous pemphigoid sera showed five of seven indirect immunofluorescence-negative bullous pemphigoid sera to bind high-molecular weight and/or low-molecular weight bullous pemphigoid antigens from epidermal extracts. We conclude that the skin explant culture system is a very sensitive method for the detection of bullous pemphigoid antibodies in all bullous pemphigoid sera.

Adolescent↗
PubMed1993

Established methods in the investigation of bullous diseases.

We have discussed an approach to the diagnosis of bullous diseases based on available and established methods. We highlighted the clinical features that help distinguish the various diseases. We then outlined a histopathologic pattern approach to the differential diagnosis and extensively discussed the value of immunofluorescence in the diagnosis of bullous diseases.

Diagnosis, Differential↗
PubMed1993

Drug-induced pemphigus.

Drug-induced pemphigus is a heterogenous group of disorders in which a drug induces acantholysis. The majority of patients have immune features of pemphigus and have a course similar to idiopathic pemphigus. Few patients do not have a detectable autoimmune process, and their eruption usually resolves with discontinuation of the associated drug. The mechanism of induction of the autoimmune process and acantholysis is not clear.

Fluorescent Antibody Technique↗
PubMed1993

Paraneoplastic pemphigus.

Paraneoplastic pemphigus is a newly recognized disease that occurs in some patients with lymphoproliferative neoplasms and occasionally, solid tumors. Patients present with an acute illness of the mucosa and skin that shares clinical and histologic features with erythema multiforme, toxic epidermal necrolysis, and pemphigus vulgaris. These patients have antibodies against a complex of epithelial proteins that are present in desmosomes and hemidesmosomes. The course is usually fatal, except in some patients who undergo total resection of their neoplasm.

Animals↗
PubMed1993

Cicatricial pemphigoid.

Cicatricial pemphigoid presents with oral or ocular inflammation and blisters that are followed by scarring. The differential diagnosis of cicatricial mucositis includes other subepithelial blistering disorders. The disease is usually chronic and can be associated with high morbidity. Treatment of severe cases with immunosuppressive agents is usually helpful.

Fluorescent Antibody Technique↗
PubMed1993

The distribution of IgA pemphigus antigen in human skin and the role of IgA anti-cell surface antibodies in the induction of intraepidermal acantholysis.

BACKGROUND AND DESIGN: IgA pemphigus is an uncommon intraepidermal vesiculopustular disease that has clinical and histologic similarity to subcorneal pustular dermatosis and pemphigus foliaceus. All patients have IgA antibodies bound to the epidermal cell surface, and half of the patients have circulating IgA anti-cell surface antibodies detected by standard immunofluorescence testing. We studied the distribution of IgA pemphigus antigen in human skin and the pathogenetic role of circulating IgA antibodies in the induction of intraepidermal vesicle formation. We used skin specimens from numerous sites of two cadavers, as well as from neonatal foreskin, and serum specimens of two patients with IgA pemphigus. OBSERVATIONS: Organ culture and immunofluorescence studies revealed the following: (1) IgA pemphigus antibodies bound preferentially to the granular layer in the vast majority of skin sites that were tested. In one cadaver, binding was preferential to the spinous layer of plantar and buttock skin. No binding was observed in oral and esophageal mucosa. (2) Neither bound nor circulating IgA antibody was complement fixing. (3) One IgA pemphigus serum specimen that was negative by standard immunofluorescence had IgA antibodies that bound the epidermal cell surface after incubation under explant culture conditions. (4) Both IgA pemphigus serum specimens induced acantholysis in skin explant cultures. CONCLUSIONS: When antibodies from one IgA pemphigus serum specimen are used, the expression of IgA pemphigus antigen in human skin shows regional variability, interindividual variability, and variability in the microscopic distribution within the epidermal cell layers. IgA pemphigus antibodies play a role in the pathogenesis of IgA pemphigus. The skin explant culture is more sensitive than is standard immunofluorescence to detect circulating IgA antibodies.

Acantholysis↗
PubMed1991

The relevance of immunohistochemical techniques in the differentiation of subepidermal bullous diseases.

There are several subepidermal bullous diseases. In some, the clinicopathological features are distinctive, whereas in others there is a variable degree of overlap that necessitates the use of ultrastructural and biochemical studies to distinguish the different diseases. In this paper, we review the literature and describe our experience using simplified immunological techniques in the diagnosis of subepidermal bullous diseases.

Diagnosis, Differential↗
PubMed1989

Definition of bullous pemphigoid antibody binding to intracellular and extracellular antigen associated with hemidesmosomes.

Bullous pemphigoid (BP) antibodies are deposited predominantly in the lamina lucida in vivo; however, circulating BP antibodies bind in vitro to the cytoplasmic plaque of basal cell hemidesmosomes. We examined the ability of IgG in nine BP sera to bind to intracellular or extracellular antigen. On skin cryosections, indirect IF showed IgG bound to basement membrane zone (BMZ) and indirect ImmunoEM confirmed intracellular binding on the cytoplasmic plaque of hemidesmosomes. In contrast, when normal skin was exposed to BP serum in organ culture, direct IF showed fainter linear deposition of IgG along the BMZ, and direct ImmunoEM demonstrated extracellular IgG binding in the lamina lucida, predominantly beneath hemidesmosomes. Four of nine sera showed complement fixation on indirect IF samples (IgG bound to intracellular antigen) and three showed complement fixation on direct IF specimens (IgG bound to extracellular antigen). Three of the nine sera contained complement fixing antibodies detectable only in antibody populations specific for intracellular or extracellular antigen. Western immunoblots showed that five of nine sera recognized a 240-kD protein and four of nine recognized a 180-kD protein. There was no correlation between the presence (or absence) of either band and the detection of complement fixing antibodies specific for intracellular or extracellular antigen. BP autoantibodies bind both intracellular and extracellular antigen, and IgG binding exclusively to extracellular antigen that mimics the in vivo situation can be detected by using organ culture. Complement fixation may be restricted to antibodies specific for intracellular or extracellular antigen. These findings underscore the complexity of the autoantibody-antigen system in BP and have implications regarding the proposed pathogenicity of the autoantibodies.

Antigen-Antibody Reactions↗