Biomedical subjects
Publications and source records attributed to J M Schamroth.
Porokeratosis of Mibelli is an uncommon dermatosis, which may be associated with immunosuppression and may undergo malignant transformation. Due to the wide range of clinical presentations, numerous classifications have evolved, resulting in some confusion. This article examines the classification and presentation of porokeratosis and, in particular, reviews the association with immunosuppression.
Multicentric pigmented Bowen's disease is a rare form of intra-epidermal carcinoma characterised by its pigmented appearance as well as its confinement to the perineal region. Two examples of this disease are presented, illustrating the classic features of this disorder.
A rare verrucous form of Bowen's disease in a black subject is presented. Bowen's disease is extremely rare in blacks, but when it does occur, it tends to present in an atypical fashion.
Atypical Kyrle's disease developed on the limbs and on the palmar and plantar surfaces of an African man. Unusual histopathologic features, such as degenerating cells under the parakeratotic plug and eccrine duct in the parakeratotic plug, are described and the diagnostic criteria for Kyrle's disease are reviewed.
We encountered a case of elastosis perforans serpiginosa in a patient with coexisting renal disease, the first such reported association of which we are aware. The perforating disorders tend to have atypical clinical features when associated with renal disease. The exact pathogenic mechanism by which renal disease predisposes to a perforating disease remains to be elucidated but is likely to be related to minor trauma, which occurs in renal disease.
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Beta adrenergic receptor blocking agents were used in the treatment of 15 hypertensive aircrew who had failed to respond to thiazide diuretics. Atenolol (Tenormin) resulted in adequate control of blood pressure in all subjects. Side effects were minimal and insignificant. It is recommended that a cardio-selective, water-soluble beta blocker, such as atenolol, be made available to selected hypertensive aircrew.
A case of Wolff-Parkinson-White syndrome with reciprocating tachycardia from retrograde Kent's bundle conduction is described. The paroxysms of reciprocating tachycardia manifested with the unusual, and hitherto unreported, feature of only odd-numbered beats. The phenomenon is explained on the basis of alternate anterograde conduction through two A-V nodal pathways.
The long-term anti-arrhythmic efficacy of lorcainide (R15 889) was studied in 20 ambulatory postmyocardial infarction patients. Lorcainide reduced the frequency of ventricular ectopic beats by more than 70% and 90% in 17 and 11 of the patients respectively. The anti-arrhythmic response improved with long-term administration of the drug. Fourteen patients complained of insomnia during the early stages of the study, but this side-effect waned later on. On electrocardiographic examination, the P-R interval, QTc interval and QRS duration were prolonged, and T-wave changes were noted while the patients were receiving lorcainide. Lorcainide seems to be a useful addition to the available anti-arrhythmic agents, and should form part of the armamentarium against ventricular ectopic activity.
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Sotalol (Sotacor) is a beta-adrenergic receptor blocking agent, which in addition possesses class III anti-arrhythmic properties. In this study we report on the clinical effectiveness of sotalol in the suppression of ventricular ectopic beats in 20 patients suffering from ischaemic heart disease. Sotalol was compared with placebo and efficacy was determined by Holter tape monitoring. Sotalol produced an 88,5% (P < 0,001) reduction in ectopic beat frequency at the optimal titrated dosage, with relatively few physical or biochemical side-effects. In situations where ventricular anti-arrhythmic therapy is deemed necessary, especially if long-term use is considered, sotalol seems to be the agent of choice.
The clinical manifestations of sporotrichosis can be classified into three disease patterns: (1) localized lymphatic sporotrichosis, (2) fixed cutaneous (or endemic) sporotrichosis, and (3) disseminated sporotrichosis. This presentation reflects a rare disseminated form of the disease with extensive cutaneous and systemic lesions, and further illustrates the difficulty in diagnosing systemic sporotrichosis infection.