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Biomedical subjects

J E Bernstein

Publications and source records attributed to J E Bernstein.

At least 37 records · Page 2Linked to original sources
PubMed1983

Heparin-induced cutaneous necrosis unrelated to injection sites. A sign of potentially lethal complications.

Skin necrosis is a rare complication of heparin administration that is usually localized to injection sites. A 32-year-old insulin-dependent diabetic patient, receiving intravenous (IV) and low-dose heparin sodium therapy, had cutaneous necrosis in areas distant to the sites of injection. Prior to the onset of cutaneous lesions, thrombocytopenia develop]ed in the patient that may have been heparin induced. Heparin may induce the production of platelet aggregating immunoglobulins that predispose persons who are sensitive to the drug to thrombocytopenia, skin necrosis, and thrombotic events. Obesity, diabetes, and treatment with broad-spectrum antibiotics seem to increase the risk of such complications. Cutaneous necrosis secondary to heparin administration may serve as a warning of the potentially lethal complications of IV use. In patients in whom skin necrosis or thrombocytopenia develops, heparin therapy should be discontinued and anticoagulation with an oral agent should be considered.

Adult↗
PubMed1982

Antipruritic effect of an opiate antagonist, naloxone hydrochloride.

Central elicitation of itch by morphine may result from binding to opiate receptors, mimicking the physiological binding of endorphins and enkephalins to these receptors. Pretreatment of normal subjects with naloxone hydrochloride resulted in diminution or abolition of histamine-provoked itch. These results suggest an important role for central opioid peptides as mediators of the itch sensation.

Adult↗
PubMed1982

Alcohol-induced rosacea flushing blocked by naloxone.

We evaluated the roles of endogenous opioid peptides and histamine in the pathophysiology of alcohol-induced facial flushing in rosacea. Non-diabetic patients with rosacea ingested 360 ml of 6% ethanol after receiving either subcutaneous naloxone hydrochloride or oral chloropheniramine maleate. Only pretreatment with naloxone blocked the alcohol-induced rosacea flushing (AIRF), suggesting an active role of endogenous enkephalin and/or endorphin in this vascular reactivity. In this respect, AIRF is similar to chlorpropamide alcohol flushing and menopausal flushing.

Adult↗
PubMed1982

Coexisting childhood pemphigus foliaceus and Graves' disease.

We report herein the concurrent appearance of childhood pemphigus foliaceus and Graves' disease in a 14-year-old girl who was initially seen with crusted and hyperpigmented plaques on her chest, back, abdomen, and legs. The diagnosis of pemphigus foliaceus was confirmed by biopsy and immunofluorescent microscopic studies while the diagnosis of Graves' disease was based on clinical and laboratory findings. The coexistence of these two immune-mediated diseases in a single patient suggest that some persons may bear a unique predisposition to the development of two or more autoimmune-type disorders that may affect diverse organ systems.

Adolescent↗
PubMed1981

Unilateral linear nevoidal syringoma.

We here report the unusual occurrence of syringoma in a unilateral linear nevoid distribution in a 32-year-old woman. The papules were located on the right side of the chest and right arm. These lesions need to be distinguished from other linear papular eruptions.

Adenoma↗
PubMed1981

Inhibition of histamine-induced pruritus by topical tricyclic antidepressants.

Frequent antihistaminic side effects noted during treatment of depression by tricyclic drugs, as well as the high affinity of tricyclic antidepressants for H1 receptors in mouse neuroblastoma cells, suggest possible useful antihistaminic properties. We investigated the antipruritic activity of topically applied 5% solutions of doxepin hydrochloride (Adapin; Sinequan) and amitriptyline hydrochloride (Elavil) and compared such activity to that of a 5% solution of diphenhydramine and vehicle alone. Test solutions were applied to 25-cm2 areas on the flexor forearms of forty subjects, and the development of itch to single drops of eight dilutions of histamine phosphate instilled in each area was reported over a 3-minute period. The lowest concentration of histamine able to elicit unequivocal itching in each treated area was the histamine itch threshold (HIT). Doxepin, amitriptyline, and diphenhydramine all produced significantly higher mean and median HITs (p less than 0.01 than did vehicle control. Sixty-eight percent of subjects had a HIT greater than or equal to 2 x 10(-4) mg/ml in doxepin-treated areas versus 58% for amitriptyline, 53% for diphenhydramine, and 25% for vehicle. Our data suggest that tricyclic antidepressants are effective topical antipruritic agents.

Administration, Topical↗
PubMed1981

Substance P.

Explore the source record for details and available documents.

Erythema↗
PubMed1981

Inhibition of axon reflex vasodilatation by topically applied capsaicin.

Topical application of capsaicin to human skin produced an initial burning erythematous reaction which diminished over 24 hr leaving the skin unresponsive to histamine-induced axon reflex vasodilatation without altering sensitivity to pain, touch and temperature. Depletion of substance P from local sensory nerve terminals is suggested as a possible explanation for this capsaicin effect.

Adolescent↗
PubMed1981

Coexistence of localized bullous pemphigoid, morphea, and subcorneal pustulosis.

A subcorneal pustular dermatosis and a vesicobullous eruption with the clinical ad histologic features of localized bullous pemphigoid(BP) were observed in a 44-year-old woman with morphea and a recent history of phenytoin sodium-induced toxic epidermal necrolysis. Localized BP is rare and has been previously described in association with other cutaneous disorders. The coexistence of localized BP, morphea, and subcorneal pustulosis suggests that immunologic factors may play a role in all three conditions.

Adult↗
PubMed1980

Topically applied erythromycin in inflammatory acne vulgaris.

We evaluated the effectiveness of 2% erythromycin and its alcohol/propylene glycol vehicle in the treatment of three hundred forty-eight patients with inflammatory acne vulgaris. A significantly greater reduction was noted in the papulopustule count for the erythromycin-treated group compared to the vehicle-treated group. Additionally, clinical improvement, as measured by physician global ratings, was significantly greater in the erythromycin-treated group. A lower adverse reaction rate observed in the erythromycin-treated patients may result from previously demonstrated anti-inflammatory properties of this antibiotic.

Acne Vulgaris↗
PubMed1980

Effects of topical erythromycin on aerobic and anaerobic surface flora.

The contents of acne lesions from 30 men with inflammatory acne vulgaris, obtained before and at the conclusion of 4 weeks of topical 2% erythromycin therapy, were cultured on aerobic and anaerobic plates. Sensitivity testing of cultures was performed with discs containing 50 mg erythromycin, in order to ascertain the prevalence of erythromycin-resistant strains of Propionibacterium acnes and aerobic micrococci. The percentages of patients in whom erythromycin-resistant micrococci could be isolated increased from 3 to 60% during topical erythromycin therapy, but no resistant P. acnes strains were isolated either before or after therapy. Considering the widespread use of topical antibiotics, long-term studies on their ecological effects are desirable.

Acne Vulgaris↗
PubMed1980

Levodopa administration and multiple primary cutaneous melanomas.

Malignant melanoma derives from melanocytic cells that possess the special biochemical pathway for the conversion of levodopa to melanin. Levodopa is widely employed in the treatment of Parkinson's disease, and several patients receiving levodopa have been observed to have acquired melanomas, raising concern about a possible relationship between this drug and the tumor. We encountered a 74-year-old woman in whom three distinct primary melanomas developed after she had been receiving long-term therapy with levodopa and a decarboxylase inhibitor. These lesions could be distinguished histologically from epidermotropic metastatic melanoma. Although the association between levodopa and melanoma is tenuous, careful monitoring of pigmentary changes in patients receiving levodopa is advised.

Aged↗
PubMed1979

Cutaneous manifestations of angioimmunoblastic lymphadenopathy.

Angioimmunoblastic lymphadenopathy (AIL) is an uncommon immunoproliferative disorder with a presentation similar to malignant lymphoma but with a benign histopathologic picture. We report a case of a 49-year-old woman with AIL who manifested a pruritic maculopapular eruption as her presenting complaint and whose disease pursued an aggressive clinical course. Forty-four percent of patients with AIL experience a nonspecific dermatitis that in general is maculopapular and precedes other clinical symptoms by at least several weeks. AIL should be included in the differential diagnosis of any maculopapular eruption of unknown etiology accompanied by lymphadenopathy.

Bone Marrow↗