Biomedical subjects
Publications and source records attributed to E J Feuerman.
We report on a patient suffering from chronic renal failure, who developed hemorrhagic bullous pemphigoid while being treated with Furosemide. The possible association between bullous pemphigoid, renal failure, and Furosemide ist briefly discussed.
We report on two typical cases of lichen planus and lichen pigmentosus appearing after gold therapy. The characteristics of lichen planus induced by drugs are emphasized, and the literature is reviewed.
During a period of 8 years 300 cases of dermatophytoses involving both hairy areas and the glabrous skin were found to be caused by M. canis. There was scalp involvement in 60%, including 8 infants and 27 adults; most of the adults presented Kerion-like lesions and presented various clinical aspects such as seborrhea capitis, folliculitis and discoid lupus erythematosus. In the 21 patients showing invasion of the beard the clinical manifestations included superficial erythemato-squamous patches with hyperemic slightly elevated margins, folliculitis or abscess-like lesions and Kerion-like lesions. Among the lesions found on the glabrous skin there were unusual aspects of tinea faciei in 19 adults, mimicking lymphocytic infiltration, granuloma faciale or discoid lupus erythematosus. Some of the cases of tinea corporis found in 70 patients also had lesions simulating various other dermatological entities, including erythema multiforme, psoriasiform eruption, pityriasis rosea and seborrheic dermatitis. The hands were invaded in 5 adults patients, with involvement of the finger nails in one. Repeated mycologic examinations were necessary to establish the true etiology in many of these cases.
A second case of actinomycetoma due to Nocardia caviae contracted in Israel is reported. A 39-year-old female of Yemenite origin, resident in Israel for more than 15 years, presented with a sclerotic tumor mass on the dorsum of the right foot which discharged an oily purulent fluid containing minute yellowish granules. Seen in the microscopic examination of smears were thin Gram-positive filaments and bacillary elements. Culture of the crushed granules yielded small pale colonies identified as Nocardia caviae. In vitro testing of the isolate to various antibiotics, isoniaside and sulphonamides showed the organism to be more sensitive to isoniaside and tetracycline. Isoniaside was administered for one year with marked improvement and was then replaced by tetracycline due to side effects, this treatment still being continued.
Five patients had a form of pemphigus which in its early stages resembled dermatitis herpetiform, although the immunofluorescent findings were typical of pemphigus. Potassium iodide tests, performed for the first time in such patients, showed positive results in two patients. Follow-ups ranging from 5 to 14 years have shown a benign course with low to absent dosages of steroids.
Five psoriatic patients developed papular lesions of palms and soles, shortly after beginning treatment with etretinate. Histological examination in two cases was insignificant. The lesions disappeared without tapering the dose of etretinate. The fact that lesions appeared and subsided within a short period may explain why this unusual adverse reaction of etretinate therapy has not been reported previously.
A 63-year-old female who had been suffering from intractable palmoplantar keratoderma for 13 years was found to have myxedema. Shortly after institution of substitution therapy with thyroid hormone there was a striking improvement in her condition. The possibility of a causal relationship between hypothyroidism and hyperkeratosis is suggested.
The case of a lichenoid photosensitive eruption induced by hydrochlorothiazide is described. The macrophage migration inhibition factor test identified hydrochlorothiazide as the offending drug out of the several suspected drugs taken by the patient. It is suggested that an allergic reaction towards hydrochlorothiazide was involved in the development of the photosensitive lichenoid eruption in this case.
We report on an unusual case of bilateral symmetrical Bowen's disease occurring simultaneously on both legs of a 56-year-old male patient. We are not aware of a similar case reported in the literature so far.
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The coexistence of psoriasis vulgaris and bullous diseases has been described in the literature, mainly with bullous pemphigoid. In the majority of cases the bullous eruption has been thought to be related to antipsoriatic treatment. We describe nine cases of psoriasis vulgaris that were associated with bullous diseases: five bullous pemphigoid, one cicatricial pemphigoid, and three pemphigus vulgaris. The association between psoriasis vulgaris and these bullous diseases may be explained on an immunologic basis.
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Autoerythrocyte sensitization (AES) is a rare syndrome particularly among males. A young male with typical AES is herewith described. We review all seven published cases of AES in men for which details are available and compare the age of onset, somatic manifestations, associated diseases and psychiatric disturbances between the sexes. We emphasize that the criteria essential for a diagnosis of AES should include typical clinical presentation, longstanding clinical history and a positive skin test with the patient's blood. Because of the rarity of AES there is a lack of awareness regarding it among many doctors.
T-lymphocyte number and function as well as the effect of a thymic hormone on the T-suppressor cell subset were studied in 22 children suffering from psoriasis vulgaris, subdivided into two groups, those with less than 20% of total skin area involved and those with more than 20% of involvement. The T-cell number was lower in the latter group than it was in the first group or in normal controls. There was no significant difference in the functional activity of T cells in the two groups of patients. The number of T-suppressor cells was significantly lower in the psoriatic children than in normal controls, being lowest in the children showing greater skin involvement. THF, a thymic hormone isolated from calves, was found in vitro to induce T-suppressor cells in the peripheral blood of the psoriatic children, suggesting that this hormone may be able to play a role in the treatment of this disease.
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