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Biomedical subjects

J A Doyle

Publications and source records attributed to J A Doyle.

At least 55 records · Page 3Linked to original sources
PubMed1981

Cutaneous cryptococcosis simulating pyoderma gangrenosum.

A 33-year-old white man with a history of chronic ulcerative colitis presented with multiple cutaneous ulcers and an indurated cellulitic area on his right thigh. Clinically, the ulcers were considered to represent pyoderma gangrenosum. However, tissue biopsy revealed copious yeast forms that were identified as Cryptococcus neoformans. The indurated area on the right thigh later ulcerated, and tissue culture of this area also revealed Cryptococcus. This case illustrates that when pyoderma gangrenosum is diagnosed, the possibility of deep fungal infection should be considered and excluded by appropriate studies.

Adult↗
PubMed1981

Immunofluorescence in psoriasis: a clinical study of sixty patients.

Direct immunofluorescent microscopy was positive on skin biopsy specimens in thirty-one of sixty patients with various forms of psoriasis. Patients with positive immunofluorescence were classified into five main clinical subgroups: (1) psoriasis vulgaris with decreased tolerance to sunlight or ultraviolet light B (eight patients), (2) psoriatic arthritis (seven patients), (3) guttate psoriasis (five patients), (4) pustular psoriasis (four patients), and (5) "uncomplicated" psoriasis vulgaris (seven patients). Various patterns of deposition of immunoglobulins, complement, and fibrin were seen in the five subgroups, the most consistent being granular C3 at the basement membrane zone in specimens from five of the seven patients with guttate psoriasis. Direct immunofluorescent microscopy was usually negative in psoriasis vulgaris, but positive results may be anticipated in special forms of psoriasis.

Biopsy↗
PubMed1981

Staging laparotomy in cutaneous T-cell disease.

Staging laparotomy performed in 13 patients with various forms of cutaneous T-cell disease (mycosis fungoides, Sézary syndrome, cutaneous lymphoma, atrophic parapsoriasis, and alopecia mucinosa) showed evidence of visceral or lymph node involvement in three (23%) patients; in two of these patients, noninvasive investigations and staging procedures did not disclose any abnormalities. All three patients were alive after a mean follow-up period of 3 1/2 years. In the ten patients with normal findings at laparotomy, the presence of intra-abdominal lymphoma was suggested in six by noninvasive staging procedures (lymphangiogram, spleen or liver-spleen scan, and computerized tomographic scan of the abdomen). Five of these ten patients died; four of the five patients died after relentless progression of the disease and visceral involvement. Staging laparotomy may have a role in the management of cutaneous T-cell disease because noninvasive investigations may be poor indicators of the presence or absence of intra-abdominal disease. The course of these patients, even those in whom laparotomies did not show any abnormalities, emphasizes the progressive potential of cutaneous T-cell disease.

Adult↗
PubMed1981

Immunofluorescence microscopic studies of recurrent aphthous stomatitis.

Direct immunofluorescence microscopic techniques were used to identify immunoglobulins and complement in the oral biopsy specimens of 22 patients with recurrent aphthous stomatitis (RAS). Ten (45%) of 22 patients demonstrated fluorescence along the basement membrane zone, and vascular fluorescence was seen in seven patients. These findings are in agreement with those of previous immunofluorescence microscopic studies of RAS and suggest the possibility that circulating immune complexes may play a role in the tissue damage seen in this disease.

Adult↗
PubMed1981

Cowden's disease (multiple hamartoma syndrome).

Cutaneous and oral lesions appearing as verrucous papules are a regular and diagnostic finding in Cowden's disease. The lesion occur predominantly over the central portion of the face, concentrated around orifices, lips, gingiva, and tongue, and over the acral portions of the upper extremities. These skin lesions have been found to be associated with fibrocystic breast disease, carcinoma of the breast, thyroid tumors, ovarian cysts, gastrointestinal polyposis, fibromas, angiomas, and lipomas. It is important to be able to distinguish the skin lesions from simple verruca vulgaris because they serve as a cutaneous marker for existing or potential internal malignancy, especially of the breast and thyroid.

Adult↗
PubMed1981

Eosinophilic fasciitis: report of 15 cases.

Clinical and histopathologic features of 15 cases of diffuse fasciitis with eosinophilia are reviewed. The patients experienced an inflammatory scleroderma-like illness without Raynaud's phenomenon or internal organ involvement. Polyarthritis and carpal tunnel syndrome were observed. The clinical courses demonstrated the potential for spontaneous remission, relapse, and late recurrence. Histopathologic features are discussed, as is their relationship to other forms of localized scleroderma. None of the 12 patients treated with corticosteroids has had complete resolution of the skin changes after a median follow-up of 10 months. Unusual associated diseases--acute myelomonocytic leukemia and an evolving myeloproliferative disorder--were observed in two patients.

Adult↗
PubMed1980

Granuloma annulare: histopathologic and direct immunofluorescent study.

Eighteen cases of granuloma annulare were classified histopathologically and examined by direct immunofluorescence. The three different histopathologic types of granuloma annulare were compared with the result of immunofluorescence examination. No features of leukocytoclastic vasculitis were seen. Direct immunofluorescence of granuloma annulare does not reveal any consistent diagnostic pattern. Dermal desposition of fibrin in necrobiotic areas were noted in 8 cases of 18. Blood vessel and/or basement membrane deposition of IgM and C3 was inconsistent and does not support an immune complex vasculitis. Direct immunofluorescence is useful in studying the pathogenesis of granuloma annulare. The finding of fibrin, together with the histology, suggests to us a delayed hypersensitivity reaction as the dominant pathogenic event.

Complement C3↗
PubMed1979

Hyperglucagonaemia and necrolytic migratory erythema in cirrhosis--possible pseudoglucagonoma syndrome.

Necrolytic migratory erythema is the distinctive cutaneous eruption seen with glucagon-producing tumours of the pancreas. Recognition of this eruption is important because it may lead to the early diagnosis of a glucagonoma. Recently, we saw a patient who had necrolytic migratory erythema, hyperglucagonaemia, and cirrhosis of the liver with no evidence of pancreatic tumour while alive or at autopsy. Serum glucagon levels during the period of observation and during an oral glucose tolerance test suggested that the hyperglucagonaemia was not due to an occult glucagon-producing tumour but may have been the result of advanced hepatic cirrhosis.

Adolescent↗
PubMed1979

Prurigo nodularis: a reappraisal of the clinical and histologic features.

Study of 14 patients with prurigo nodularis revealed that clinically the lesions were multiple, verrucous, and discrete and were set in normal-appearing skin. Microscopically, the lesions showed a vascular acanthomatous mass. The dermal nerves showed a tendency toward hyperplasia in parallel with the epidermal and vascular changes, but no evidence of neuroma formation was seen. Electron microscopic examination showed disorganization of the normal pattern of the myelin sheaths and axons of the dermal papillary nerves. The presence of epidermal mast cells was noted in the biopsy specimens of prurigo nodules from eight of the 14 patients.

Adult↗