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Biomedical subjects

D J Hogan

Publications and source records attributed to D J Hogan.

At least 19 recordsLinked to original sources
PubMed2000

Ulcerated atrophic striae from etretinate.

Oral retinoids such as etretinate and acitretin are commonly associated with dose-dependent, mucocutaneous side effects such as dryness, peeling, and fragility. Although these effects can be extreme in some patients and even require discontinuation of treatment, thinning of skin to the point of atrophy and ulceration has never been reported in the English literature. We present the case of a patient with psoriasis in whom ulcerated atrophic striae developed during etretinate therapy. After discontinuation of etretinate, all cutaneous ulcers resolved. Subsequently, the patient had a favorable response to oral calcitriol (1,25-dihydroxy vitamin D3), a novel therapy for psoriasis.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Male pattern baldness.

BACKGROUND: Male pattern baldness, or androgenetic alopecia (AGA) in men, occurs with varying severity and age of onset. Two new treatments widely available as alternatives to 2% minoxidil are 1 mg finasteride and topical 5% minoxidil. Finasteride is a 5 alpha-reductase inhibitor available by prescription only; 5% minoxidil is available over the counter. METHODS: We searched MEDLINE to identify all articles on AGA and its pharmacologic therapies. RESULTS: We found limited information on AGA in peer review medical journals. Associated diseases include psychologic disorders and coronary heart disease. Hair growth is unpredictable and limited for all pharmacologic therapies, with the vast majority of treatment studies being industry sponsored. CONCLUSION: AGA is not easy to treat. Finasteride and 5% minoxidil offer new therapeutic options to the balding man. Treatment options may improve as new drugs are further investigated.

5-alpha Reductase Inhibitors↗
PubMed1999

Evaluation and management of the "red face". Interview by K. Watsky and M. Rothe.

Patients presenting with a "red face" challenge clinicians to consider a broad differential diagnosis that includes contact dermatitis. The diagnosis may be obscured or complicated by underlying actinic damage or rosacea. Unraveling this Gordian knot to arrive at a precise and accurate diagnosis takes patience and practice. The collective experience of our invited group of expert clinicians sheds light on this process.

Acne Vulgaris↗
PubMed1999

Leg ulcers: a common problem with sometimes uncommon etiologies.

In the U.S., leg ulcers present a significant clinical problem, occurring at a rate of approximately 600,000 new cases per year. In most cases, the cause of ulceration is venous or arterial in nature. One uncommon but significant cause of leg ulcers is sqaumous cell carcinoma (SCC). Although the incidence of SCC is higher in white than black populations, blacks with SCC typically exhibit involvement of areas of the skin that are not chronically sun-exposed, especially the lower extremeties. Predisposing factors include burn scars, chronic infection or ulceration, and chronic discoid lupus erythematosus. Leg ulcers of atypical presentation or those that fail to heal should alert the clinician to consider uncommon etiologies.

Aged↗
PubMed1999

Pemphigus foliaceus and renal cell carcinoma.

It is possible to distinguish the various forms of pemphigus from one another using clinical, histologic, and immunologic criteria. Paraneoplastic pemphigus, a recently defined type that is severe and often fatal, is associated with an underlying malignancy. We present the second reported case of pemphigus associated with renal cell carcinoma. We do not believe that either case represents paraneoplastic pemphigus, which suggests the possibility of some other link between these two diseases.

Aged↗
PubMed1999

Contact dermatitis for primary care providers.

Contact dermatitis is an eczematous dermatitis developing at a site where the skin has been in direct contact with the cutaneous irritant or allergen from the environment. Irritant contact dermatitis (ICD) is the most common form. Allergic contact dermatitis (ACD) is inflammation of the skin caused by an antigen that elicits a type IV hypersensitivity reaction. Clinical evaluation and judgment are a critical part of the process. Patch testing in an objective method to aid in differentiating ACD from ICD and of verifying responsible allergens.

Algorithms↗
PubMed1995

Perioral dermatitis.

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMed1994

Seabather's eruption. Clinical, histologic, and immunologic features.

BACKGROUND: Seabather's eruption (SE) is a highly pruritic eruption under swimwear that occurs after bathing in the ocean. Its cause has been unknown. Few data have been collected since the classic description by Sams in 1949. OBJECTIVE: Our purpose was to describe the clinical and histopathologic findings in SE and to confirm the cause. METHODS: Patients with a pruritic eruption that developed after swimming were seen within 1 week of onset. Skin biopsy specimens and sera were obtained in selected cases. Water samples taken from areas of active SE outbreaks were examined for a causative organism. Sera were tested by enzyme-linked immunosorbent assay for reactivity to this organism. RESULTS: In southeast Florida, during a 4-month period, 70 patients with SE were seen. Inflammatory papules and pruritus were noted within hours of exposure. Eruptions were maximal in areas covered by a bathing suit. Children were more likely than adults to have systemic symptoms. The average duration of the eruption and pruritus was 12.5 days, with recurrences in 4.3% of patients. Histopathologic examination revealed a superficial and deep perivascular and interstitial infiltrate consisting of lymphocytes, neutrophils, and eosinophils. Water samples contained many cnidarian larvae, later grown to maturity and identified as Linuche unguiculata (thimble jellyfish). Enzyme-linked immunosorbent assay demonstrated in patients' sera high IgG levels specific for L. unguiculata. CONCLUSION: SE is a severely pruritic marine dermatosis that resolves spontaneously within 2 weeks. Therapy is symptomatic but often ineffective. Sera from affected persons showed specific reactivity to L. unguiculata.

Adolescent↗
PubMed1993

Histopathology of actinic prurigo.

Actinic prurigo (AP) is an idiopathic familial photodermatosis seen in American Indians. We report on 17 patients; 16 had dermatitis and one had actinic cheilitis. Ten patients had acute dermatitis and six had chronic dermatitis. The histologies of acute AP and polymorphous light eruption (PLE; limited concept) are eczematous and indistinguishable. Both show spongiosis, superficial (and sometimes deep) perivascular lymphocytic infiltrates, and papillary dermal edema. Both also show vacuolar degeneration of the basal layer. In contrast, the chronic lichenified AP lesions are associated with marked hyperkeratosis, acanthosis, elongation of the rete ridges, and tissue repair. The large lymphoid germinal centers in the lamina propria are the main features of the lip histology. Seven biopsies were positive in the basal membrane zone on direct immunofluorescent testing, four were negative, and one was inconclusive. IgM was present in six and C3 in two. These immunofluorescent results are probably not significant. Immunofluorescent testing of the lip was negative. Although it is not possible to distinguish acute AP from PLE histologically, it is possible to differentiate the two conditions when chronic AP changes are present.

Arm↗