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Biomedical subjects

J J Meffert

Publications and source records attributed to J J Meffert.

At least 37 records · Page 2Linked to original sources
PubMed1998

Primary cutaneous Aspergillus ustus infection: second reported case.

We describe the second case of primary cutaneous Aspergillus ustus infection in an immunocompromised patient. Cutaneous aspergillosis was confirmed both by culture and positive fluorescent antibody staining. Few species of Aspergillus are pathogenic in human beings, and fewer still cause primary cutaneous disease. The only other reported case of aspergillosis from Aspergillus ustus occurred in an immunosuppressed patient who was temporally and geographically separated from ours.

Anti-Inflammatory Agents↗
PubMed1998

A polypous carbuncle.

A carbuncle usually presents as a deep-seated mass of fistulous tracts between infected hair follicles. We present a case in which what appeared to be an inflamed, benign neoplasm turned out to be a very unusual presentation for this condition, the first we could find in the literature. A 62-year-old woman presented with a bothersome 'mole' on her flank of uncertain duration but it was initially pruritic and irritated by her clothing. Owing to the pain, she wanted its removal. A 1 cm soft, pink, stalked papule revealed multiple, closed,, comedo-like spots on its surface (Fig. 1). The lesion was mildly tender and freely mobile on a broad-based stalk. A pre-biopsy diagnosis of irritated intradermal nevus or neurofibroma was made, and the lesion was blade-shaved flush with the skin surface. Histologically, the papule demonstrated small abscesses which seemed to connect, as well as foci of granulation tissue and marked dermal edema (Fig. 2). Fragments of infundibular epidermis were found throughout the lesion. No residual melanocytic or neural neoplasms were identified.

Carbuncle↗
PubMed1998

Treatment of oral granulation tissue with the flashlamp pulsed dye laser.

BACKGROUND: Surgical excision and debridement is the standard therapy for cutaneous and intraoral pyogenic granulomas (PGs). Occasionally the mass of granulation tissue proves unresponsive to the usual treatment methods. OBJECTIVE: We report a case in which the flashlamp pulsed dye laser (PDL), previously reported as useful in cutaneous PGs, was used in a patient with persistent granulation tissue around dental implant posts. METHODS: An illustrative case is presented with a brief discussion of the use of lasers in dentistry and in the treatment of PGs. RESULTS: Previously resolute tissue responded well to a series of treatments with the PDL. CONCLUSION: The PDL may have utility in this oral condition, providing a new venue for cooperation between dentists and dermatologists.

Aged↗
PubMed1998

Eczematous hypersensitivity from aqueous vitamin K injection.

Hypoprothrombinemic states are commonly treated with injectable vitamin K. Cutaneous vitamin K hypersensitivity can manifest as eczematous or sclerodermoid lesions and historically has been related to the use of fat-soluble vitamin K1. We present a case of warfarin-induced hypoprothrombinemia treated with aqueous vitamin K1, which resulted in the appearance of eczematous vitamin K1 hypersensitivity.

Adult↗
PubMed1998

Cutaneous sporotrichosis presenting as a keratoacanthoma.

Sporothrix schenckii is a ubiquitous dimorphic fungus with a variety of clinical presentations, including imitation of other diseases such as pyoderma, rosacea, and pyoderma gangrenosum. A case in which sporotrichosis appeared as a keratoacanthoma-like nodule on the lower lip of a young woman is presented, with treatment considerations and diagnostic pitfalls.

Adult↗
PubMed1998

Primary anetoderma.

Primary anetoderma is a rare disorder characterized by sac-like herniations and depressions in previously normal skin. On histologic examination, elastic fibers are destroyed by an inflammatory infiltrate. We describe a striking case of primary anetoderma and review the classification, differential diagnosis, causes, and treatment.

Adult↗
PubMed1998

The "teepee" sign in inflammatory scalp disease.

Psoriasis and other diffuse inflammatory diseases of the scalp can cause a unique physical findings that we call the "teepee sign" because the hair forms pyramidal tufts at regular intervals that resemble an American Indian encampment. A pathological mechanism for this finding is proposed, with the description of two cases in Air Force basic trainees, one of a severe seborrheic dermatitis and the other psoriasis. The significance with regard to physical qualification for entry into military service is discussed.

Adolescent↗
PubMed1997

'Dimpling' is not unique to dermatofibromas.

The dimpling of the skin with lateral compression or 'Fitzpatrick's sign' is considered by many to be pathognomonic for dermatofibromas (DFs). Despite the description of this sign in all major textbooks, not all DFs dimple and all that dimple are not DFs. Other diagnostic investigations such as the use of dermatoscopy may help to confirm the clinical suspicion of DF.

Biopsy↗
PubMed1997

Mees' lines in a patient with multiple parasitic infections.

Mees' lines, or transverse striate leukonychia, are classically associated with arsenic poisoning, but have been described in other cases of acute or chronic illness. Their pathogenesis is thought to be a disruption of nail plate keratinization secondary to systemic stress. Mees' lines are observed in a patient with helminthic and amebic infections and no history of arsenic exposure. This case demonstrates another clinical setting in which Mees' lines can appear, providing further evidence that Mees' lines may chronicle systemic disease.

Adult↗
PubMed1997

Necrobiotic xanthogranuloma with paraproteinemia: an evolving presentation.

Necrobiotic xanthogranuloma with paraproteinemia is a progressive and destructive process that is often confused both clinically and histologically with other granulomatous and xanthomatous entities. It was first described by Kossard and Winkelmann in 1980. Prior to this, the entity was reported under a variety of names such as atypical multicentric reticulohistiocytosis with paraproteinemia, atypical xanthoma disseminatum, and atypical necrobiosis lipoidica. A 69-year-old woman experienced slightly pruritic and painful papules, plaques, and nodules. Initial biopsy specimens showed a granulomatous process consistent with granuloma annulare. Later biopsy specimens demonstrated histologic changes indicative of necrobiosis lipoidica. The most recent histologic findings are those of necrobiotic xanthogranuloma, with results of laboratory studies revealing a coexistent IgG kappa paraproteinemia. Patients with necrobiotic xanthogranuloma who demonstrate a benign monoclonal proteinemia and are evaluated for several years show a 9 to 11 percent risk of myeloma, amyloidosis, or macroglobulinemia. Multiple treatment regimens have been attempted, none of which are curative. We propose that this entity may be part of an evolutionary process that may start as a granulomatous entity and culminate in a xanthogranulomatous process with an accompanying paraproteinemia.

Aged↗
PubMed1996

Intradermal nodular fasciitis presenting as an eyelid mass.

BACKGROUND: Nodular fasciitis is a fibroblastic proliferation in which nodules, most commonly appearing on the extremities, develop suddenly and rapidly. Although excisional biopsy is curative, the nodules will often resolve spontaneously; however, the histologic appearance of a pleomorphic spindle cell neoplasm with frequent mitotic figures may raise concern of a more malignant neoplasm and lead to unnecessary and overly aggressive therapy. METHODS: A case of nodular fasciitis presenting in an unusual location, intradermally at the lateral canthus, is discussed. RESULTS: Review of the recent literature from other disciplines reveals new insights into the etiology and diagnostic options (fine needle aspiration, tomography, other imaging techniques) for this puzzling disease. CONCLUSIONS: When nodular fasciitis occurs in an unusual location, such as on the head and neck or at an intradermal location, it will not present as the deep, mobile, nontender nodule described in the dermatologic literature. Fine-needle aspiration and modern imaging techniques may help in the diagnosis and prevent unnecessary surgery for a self-limited condition.

Adult↗
PubMed1995

Lichen sclerosus.

Lichen sclerosus, usually appearing in the dermatologic literature under the names of lichen sclerosus et atrophicus, balanitis xerotica obliterans, and kraurosis vulvae, is an inflammatory disease with a multifactorial origin. A past association of lichen sclerosus and genital squamous cell carcinoma is not as close as once thought. Once considered primarily a surgical problem, especially when the genitals were involved, lichen sclerosus will respond to a variety of systemic and topical therapies.

Autoimmune Diseases↗
PubMed1995

Bullous drug eruption to griseofulvin in a man with Hailey-Hailey disease.

Hailey-Hailey disease (chronic benign familial pemphigus) is a blistering disease characterized by episodic maceration and erosions in areas subject to friction and trauma such as the neck, axilla, and other intertriginous areas. We report a case in which a griseofulvin-induced drug eruption led to a generalized vesiculobullous eruption requiring treatment in a burn treatment center. This emphasizes that Hailey-Hailey disease, usually confined to relatively small areas, has the potential to cause blistering throughout the epidermis under certain conditions.

Administration, Cutaneous↗