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Biomedical subjects

J S Wieselthier

Publications and source records attributed to J S Wieselthier.

11 recordsLinked to original sources
PubMed1996

Panniculitis: recent developments and observations.

Dermatopathologists rarely greet a biopsy of panniculitis with total confidence that a specific, definitive diagnosis will be rendered. As with many other areas in dermatopathology, our understanding of the pathogenesis of many forms of panniculitis is incomplete. This article examines a subset of panniculitis primarily from a pathogenetic standpoint, with the intention of providing a differential diagnosis for those cases in which ischemic changes are seen in the subcutis. The diverse group of conditions evoked by this approach also shares the distinction of having been the focus of nosologic and causative controversy, both historically and currently. In particular, stasis-associated sclerosing panniculitis, vascular calcification-cutaneous necrosis syndrome (calciphylaxis), oxalosis, and nodular vasculitis-erythema induratum are examined in depth. Erythema nodosum and variants, other granulomatous panniculitides, and panniculitides showing cytophagocytosis are also discussed with current perspectives.

Diagnosis, Differential↗
PubMed1996

Cutaneous metastasis of ocular malignant melanoma. An unusual presentation simulating blue nevi.

Cutaneous metastases from primary ocular melanoma are not well characterized in the literature, and the occurrence of cutaneous metastases in the absence of other systemic involvement is distinctly uncommon. A case of primary ocular malignant melanoma is reported in which the only evidence of metastatic disease initially was skin lesions that simulated cutaneous blue nevi. Knowledge of this patient's history of ocular malignant melanoma coupled with a review of the clinical and histopathologic specimens was necessary to arrive at the diagnosis. This case illustrates and characterizes an unusual presentation of cutaneous metastases of primary ocular melanoma.

Ciliary Body↗
PubMed1994

Bacillary angiomatosis in an immunocompetent child: the first reported case.

Bacillary angiomatosis, an infectious process associated with Rochalima spp., was thought until recently to be restricted to HIV-infected or otherwise immunosuppressed patients. In 1993, bacillary angiomatosis was reported in several immunocompetent adults. An extensive literature review failed to find references to bacillary angiomatosis in immunocompetent children. We describe a 6-year-old female who presented with a single, rapidly growing, friable, erythematous papule on her neck. Histologic examination of a biopsy specimen confirmed the diagnosis of bacillary angiomatosis. The patient was otherwise healthy, and her physical examination was normal. Laboratory studies, including HIV serology, were normal. The patient was treated with six weeks of oral erythromycin without evidence of recurrence. We present and discuss the implications of the first case of bacillary angiomatosis in an immunocompetent child.

Angiomatosis, Bacillary↗
PubMed1993

Contact dermatitis.

Contact dermatitis is a common inflammatory skin disorder caused by exposure to various antigens and irritants. It is associated with significant morbidity, and it is one of the most common reasons for worker's compensation claims for skin disease. Based on the mechanism by which contact allergy develops, several types are recognized, including allergic contact dermatitis, irritant contact dermatitis, contact photo-dermatitis and contact urticaria. The clinical presentation of contact dermatitis, regardless of the mechanism, ranges from localized vesicles and bullae on erythematous skin in acute stages to erythematous lichenified plaques in chronic stages. Diagnosis is suggested by the localization of the eruption and the history of exposure to an offending agent. Treatment includes removal of the offending agent in conjunction with use of anti-inflammatory steroid creams, antihistamines and, in severe cases, oral corticosteroids.

Adult↗
PubMed1992

Inefficacy of extracorporeal photochemotherapy in the treatment of B-cell chronic lymphocytic leukemia: preliminary results.

Because extracorporeal photopheresis has been shown to be clinically effective in Sezary syndrome, a disease characterized by a circulating malignant clone, we initiated a pilot study of its use in B-cell chronic lymphocytic leukemia (B-CLL) to see if it could be similarly effective. We treated three patients with Rai stage III and IV B-CLL with photopheresis (3 consecutive days a week every 3 weeks) and followed serial clinical and immunologic parameters. While we noted no major toxicity, there was neither clinical response to treatment nor marked improvement in white counts or mitogen assays. We conclude that photopheresis was not effective in inducing remission in this pilot study of advanced stage B-CLL patients.

Adult↗
PubMed1990

Sézary syndrome: diagnosis, prognosis, and critical review of treatment options.

Sézary syndrome is a form of leukemia-lymphoma characterized clinically by erythroderma, pruritus, adenopathy, and circulating atypical cells with cerebriform nuclei. Histologically, atypical lymphocytes in the dermis and Pautrier's microabscesses are often present in skin biopsy specimens. Immunologic findings that support a diagnosis of Sézary syndrome include a predominance of CD4+ lymphocytes in both skin biopsy specimens and peripheral blood. Cytogenetic studies that demonstrate aneuploidy and DNA probe analysis that shows gene rearrangement for the beta-subunit of the T cell receptor are the latest, most sensitive, and specific methods for identifying the clonal nature of the disease. Various staging systems are used. We review the various treatments for Sézary syndrome, including the newer, biologically based investigational therapies, (e.g., antithymocyte globulin, monoclonal antibodies and other immunostimulants, retinoids, cyclosporine, interferon, and extracorporeal photopheresis). Extracorporeal photopheresis and some chemotherapeutic agents appear to produce the best results in terms of response and remission duration with minimal toxicity. However, more multicenter controlled clinical trials are needed to determine the most effective single or combined therapeutic regimen.

Aged↗