[Reticular erythematous mucinosis].
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Biomedical subjects
Publications and source records attributed to E J Feuerman.
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We reported two cases of subcorneal pustular dermatosis (Sneddon-Wilkinson disease) which developed several hours after performance of an echography. To the best of our knowledge, there are as yet no reports in the literature relating performance of echography with the appearance of this rare disease. The possible explanation of the relation between the dermatologic disorder and the performance of echography is discussed.
This paper describes a case representative of a group of people who are troubled by cosmetic blemishes but are unable to verbalize their feelings. After appropriate treatment, they are able to verbalize their feelings and they feel great relief.
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In a patient with subcorneal pustular dermatosis (SPD) the appearance of new pustular lesions characteristic of the disease was triggered by two episodes of drug eruption (induced by dapsone and quinidine sulphate respectively) and by the intra-dermal injection of the recall antigens Candida and streptokinase-streptodornase, performed for evaluation of delayed hypersensitivity. Both episodes of drug eruption were probably the result of an immediate-type hypersensitivity reaction towards the offending drugs, as indicated by positive mast cell degranulation tests.
Our previous findings have shown that the plasma of cancer patients lacks a factor (LCMEF) that is characterized by its ability to enhance lymphocytic cortisol metabolism. In the present study we have examined whether this phenomenon also appears in patients suffering from basal cell carcinoma, a seldom metastasizing disease, and in patients with ulcerative colitis regarded to be at high risk of developing cancer. Known concentrations of human lymphocytes from healthy donors were incubated with cortisol in media containing 50% phosphate-buffered saline (PBS) and 50% of one of the following additions: 1) homologous plasma, 2) plasma from the patients being tested, or 3) additional PBS. Previous findings showed that the plasma of cancer patients has a mean metabolism-enhancing rate of 62% of that obtained with homologous plasma. In the present work the results were as follows: basal cell carcinomas--98%, gastrointestinal carcinomas--63%, ulcerative colitis--95%, and healthy donors--90%. The results with regard to cancer patients show that lack of LCMEF does not characterize basal cell carcinoma and ulcerative colitis. Hence, it is possible that the disappearance of LCMEF 1) does not characterize ulcerative colitis as long as a malignant tumor does not appear and 2) does not characterize seldom metastasizing disease (basal cell carcinoma).
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A 71-year-old female with a widespread double mycotic infection caused by C. Albicans and T. rubrum was discovered to be suffering from mycosis fungoides. Clinically she was found to have large, polycyclic erythematous plaques with scaly, slightly infiltrated borders, covering almost all areas of the glabrous skin, and also involving the scalp (with no hair penetration), the soles and palms, toe-webs, finger and toe nails; there was also perleche and oral thrush. Cultures yielded C. albicans from most of the skin lesions, from the scalp, mouth, finger nails and urine and stool specimens, and T. rubrum from intermingled skin specimens, from the palms and soles and toe-nails. Blood culture was negative as were intracutaneous tests with fungal antigens and tuberculin. Histological examination confirmed the fungal invasion of the horny layer and at the same time revealed an underlying pathologic picture of mycosis fungoides, the lesions having been masked by the mycotic eruption. Intensive cytostatic and antifungal therapy led to a transient improvement but shortly thereafter there was a relapse of the fungal and lymphoproliferative manifestations and the patient died in septic shock.
A 46 year old woman had suffered from Erythema anulare centrifugum Darier (EAC) since 20 years. During a rush of the erythema numerous seborrhoic keratoses appeared (Leser-Trélat sign/LTS). Clinical examination revealed a ductular carcinoma of the breast. During the last two years, both types of lesions increased although the tumor had been treated. In addition, the patient developed several basal cell epitheliomas at forehead and chest.
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A study of macrophage migration inhibitory activity (MIA) in serum was carried out in four psoriatic patients with normal renal function who were undergoing peritoneal dialysis (PD) as a method of therapy. Before weekly PD treatment, the MIA was negative in these patients. whereas immediately thereafter it was positive. In two of these patients the appearance of MIA paralleled the clinical improvement observed. The increase in MIA observed after each PD was of short duration, usually being followed by a subsequent decrease prior to the next PD. Seven uremic patients who were similarly studied for the presence of MIA before and after PD did not show this pattern of response. It is suggested that the appearance of MIA in psoriatic patients undergoing PD as a method of therapy reflects the extraction of a "dialysable serum factor", which may be associated with cell-mediated immunity as well as with the clearing of skin lesions observed in these patients.
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The case of a patient with mixed-type cryoglobulinemia and cutaneous necrotizing vasculitis, who later suffered from relapsing polychondritis affecting the auricle and the nose, is described. To the best of our knowledge, this combination is unique.