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Biomedical subjects

D N Silvers

Publications and source records attributed to D N Silvers.

At least 55 records · Page 3Linked to original sources
PubMed1991

Histologic evaluation of nail clippings for diagnosing onychomycosis.

Nail clippings from patients suspected of having onychomycosis were processed for histologic evaluation in the same manner as routine skin with the addition of a chitin-softening solution prior to processing. The sections were stained by the periodic acid-Schiff method and examined for fungal hyphae. The results were compared with the results of fungal cultures from the same nail. Our findings indicate that routine histopathologic analysis of the nail plate alone is a useful complementary method to fungal culture for diagnosing onychomycosis.

Diagnosis, Differential↗
PubMed1991

Post-cardiac transplant reactivation of Chagas' disease diagnosed by skin biopsy.

Reactivation of Chagas' disease in immuno-compromised hosts may represent a recognizable clinical syndrome that can be diagnosed by examination of skin biopsy specimens of characteristic lesions resembling ordinary bacterial cellulitis. This syndrome appears to result in significant morbidity, which can be avoided with the institution of prophylactic therapy for Chagas' disease. An awareness of this complication of immunosuppression is of paramount importance for the thousands of asymptomatic persons infected with Chagas' disease currently living in the United States and abroad.

Adult↗
PubMed1990

Janeway lesions and Osler's nodes: a review of histopathologic findings.

The histologic findings in Osler's nodes and Janeway lesions have been reported rarely; we found descriptions of only 10 such cases, mostly from the late nineteenth- and twentieth-century French literature. We found gram-positive coccobacilli in the dermal abscess of a Janeway lesion from a patient with bacterial endocarditis. This finding suggests that septic microemboli are the cause.

Abscess↗
PubMed1990

Cutaneous lesions of disseminated histoplasmosis in human immunodeficiency virus-infected patients.

Disseminated histoplasmosis is being diagnosed more frequently in persons infected with the human immunodeficiency virus and is often the initial manifestation of the acquired immunodeficiency syndrome (AIDS). Disease-related cutaneous features of HIV-associated disseminated histoplasmosis are defined as mucocutaneous lesions from which fungal organisms were either cultured or demonstrated histopathologically. We report four HIV-seropositive patients with disseminated histoplasmosis who had culture-positive skin or oral lesions of histoplasmosis and review the specific cutaneous manifestations of HIV-associated disseminated histoplasmosis. Including our patients, disease-related skin and/or mucosal lesions were present in 11% of patients (26% of 239) with HIV-associated disseminated histoplasmosis. The possibility of disseminated histoplasmosis should be considered in all HIV-infected persons and in persons with AIDS risk factors who have fever, weight loss, hepatosplenomegaly, and new cutaneous lesions. An early skin or mucosal biopsy specimen for crushed tissue preparation, histologic evaluation, and fungal culture is a simple, rapid diagnostic procedure.

Adult↗
PubMed1990

Benign neonatal hemangiomatosis: review and description of a patient with unusually persistent lesions.

Benign neonatal hemangiomatosis (BNH) is a disorder in which multiple cutaneous hemangiomas appear at birth or shortly thereafter; visceral complications are absent. While previously reported cases of BNH emphasize the relatively early spontaneous regression of the cutaneous lesions, we describe a patient in whom new lesions arose and old ones persisted during the first year of life. The features of BNH are contrasted with those of diffuse neonatal hemangiomatosis (DNH), a dermatosis with a more grave prognosis.

Female↗
PubMed1990

Athlete's nodules. Treatment by surgical excision.

Athlete's nodules are connective tissue nevi of the collagen type (collagenomas) which appear as thick dermal masses at sites of chronic trauma. They have been described as occurring on the dorsum of the feet, knees, and knuckles of surfers, boxers and marble players. Recurrent minor blunt trauma and pressure are aetiological factors in this condition. We report a 54-year-old man with dermal nodules on the dorsal surface of his feet. These lesions initially appeared during his participation as a player on a high school football team. They were attributed to the chronic pressure of his high-laced athletic sneakers and frequent minor injuries to the involved areas. We describe the successful treatment of our patient's lesions by surgical excision. We also discuss the differential diagnosis and other therapeutic options for athlete's nodules.

Diagnosis, Differential↗
PubMed1990

Cutaneous leishmaniasis in Guatemala: comparison of diagnostic methods.

A comparison was made of methods used to diagnose suspected cutaneous leishmaniasis in Guatemala. The most sensitive method was a combination of thin smears made from superficial scrapings of the ulcers and inoculation of culture medium with either aspirates or scrapings. The diagnosis was confirmed in 252 (70%) of 362 patients. Ability to cultivate Leishmania was correlated with the concentration of amastigotes seen on thin smears. Leishmania were cultured in 42 (27%) of 153 patients with no amastigotes found in 400 oil-immersion fields and in 174 (83%) of 209 patients with at least 1 amastigote. No difference in diagnostic outcome was found when we compared smears or cultures taken from the center or the border of the ulcer or from an incision made tangential from the ulcer. We found no difference when we compared smears obtained with scalpels, capillary tubes, or dental broaches. The use of scrub brushes soaked in iodine neither decreased the rate of culturing parasites nor decreased contamination rates.

Animals↗
PubMed1990

Detection of human papillomavirus DNA in penile lesions histologically negative for condylomata. Analysis by in situ hybridization and the polymerase chain reaction.

The purpose of this study was to analyze penile lesions that lacked the histological features of condylomata for human papillomavirus (HPV) DNA. Most of these lesions were detected in men whose partners had an HPV-related lesion. Sequences homologous to HPV DNA were detected in 12 of 84 (14%) lesions using in situ hybridization analysis; nine of these lesions contained HPV 6 or 11. HPV DNA was found in 25 of 26 (96%) penile condylomata, all but two of which contained HPV 6 or 11. Using the highly sensitive polymerase chain reaction (PCR), we also detected HPV DNA in four of 20 (20%) of the penile lesions that lacked the histological features of condylomata negative for HPV by in situ analysis. Most of the lesions that were identifiable only after the application of an acetic acid solution were HPV negative when tested with either technique. We conclude that HPV DNA can be found in penile biopsy specimens that do not demonstrate the unequivocal histological features of condylomata but that the detection rate is much lower than for condylomata even when analyzing tissues in men at high risk for HPV-related lesions by PCR. This study underscores the need for caution when interpreting such tissues and the usefulness of in situ analysis for detecting assumed viral proliferation in noncondylomatous lesions.

Base Sequence↗
PubMed1990

Acute myelomonocytic leukemia presenting as a benign-appearing cutaneous eruption.

Aleukemic leukemia cutis is a rare condition in which patients have skin lesions containing leukemic cells before evidence of leukemia can be detected in the peripheral blood. There are only 23 cases of this phenomenon documented in the English literature. We describe a 62-year-old woman who developed a diffuse, clinically benign-appearing cutaneous eruption, which histologically showed an atypical infiltrate of cells, 4 months before leukemic cells were found in her peripheral blood and the diagnosis of acute myelomonocytic leukemia was made by bone marrow aspiration. This case illustrates the difficulty in diagnosing leukemia cutis from examination of routine histologic sections and the importance of specialized marker studies in determining the cause of an atypical cellular infiltrate of the skin. It also illustrates how leukemia cutis can masquerade as a clinically benign-appearing cutaneous eruption in a seemingly healthy patient with normal blood parameters.

Antineoplastic Agents↗
PubMed1990

Coma blisters: report and review.

Coma blisters are self-limited lesions that occur in the setting of coma of various causes, but are most commonly associated with barbiturate overdose. Examination of a skin biopsy specimen demonstrates the characteristic presence of eccrine sweat duct necrosis. Although the exact cause of coma blisters remains unknown, they are not related to underlying infections or rheumatologic disorders, and do not contraindicate the continued therapeutic use of barbiturates.

Adult↗
PubMed1989

Malignant mesothelioma: diagnosis by skin biopsy.

We report a case of malignant mesothelioma in which the tissue diagnosis was established by examination of a skin biopsy specimen. We also review the cutaneous manifestations of malignant mesothelioma. To our knowledge this is only the second reported case diagnosed primarily by examination of tissue from the skin.

Abdominal Muscles↗
PubMed1988

Mucosal melanotic macule, reactive type: a simulation of melanoma.

Two patients with spontaneously resolving hyperpigmented patches of the oral mucosa are reported. Histologically, lesions in both cases showed large pigment-laden dendritic cells singly dispersed at all levels of the epidermis, which simulated in situ melanoma. The absence of such cells in the basal layer of the epidermis served to histologically distinguish these lesions from a biologically malignant melanocytic tumor. Spontaneous resolution in both patients suggests that the condition is reactive. We propose the term mucosal melanotic macule, reactive type, for this lesion, which has been described previously under the misnomer oral melanoacanthoma.

Adolescent↗
PubMed1987

Role of preoperative topical 5-fluorouracil in preparation for Mohs micrographic surgery of extramammary Paget's disease.

The true extent of the skin affected in extramammary Paget's disease is frequently well beyond its clinical borders. A case of extramammary Paget's disease of the scrotum was treated with Mohs micrographic surgery. Prior to surgery, 5-fluorouracil was applied topically for 10 days. This resulted in a sharply delineated, erythematous patch of biopsy-proved extramammary Paget's disease well beyond the original clinical borders. This increased the visible area of disease by 60%. Mohs micrographic surgery detected microscopic extramammary Paget's disease approximately 1 cm beyond the erythematous borders. The location of disease farthest from the margins was in the direction toward which this erythema was most advanced when the application of 5-fluorouracil was discontinued. At the time of writing, 3.5 years after treatment, the patient was free of disease. Topical 5-fluorouracil may have a role as an adjunct to surgery by highlighting subclinical areas of extramammary Paget's disease. It may also be useful postoperatively to detect early disease recurrence.

Aged↗
PubMed1987

Clinical and histologic features of pityriasis lichenoides et varioliformis acuta in children.

Pityriasis lichenoides et varioliformis acuta (PLEVA) is commonly thought of as a disease of young adults, yet we identified five cases, involving patients who were 3, 5, 6, 8, and 11 years of age, among 13,000 consecutive specimens submitted to a general dermatopathology laboratory during a 15-week period. The clinical and histologic features of PLEVA in our cases were similar to those reported for adults, except that no lesions were observed on the scalp or mucous membranes of children. A high index of suspicion and biopsy specimens of suspected lesions are often needed to differentiate PLEVA from other papular and crusted eruptions seen in the pediatric age group. These include reactions to arthropods, Gianotti-Crosti syndrome, varicella, and erythema multiforme. Histologically, papular eczema and pityriasis rosea may be misdiagnosed as PLEVA.

Acute Disease↗