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Biomedical subjects

K F Helm

Publications and source records attributed to K F Helm.

At least 37 records · Page 2Linked to original sources
PubMed1997

The immunohistochemical characteristics of the basosquamous cell carcinoma.

BACKGROUND: The basosquamous cell carcinoma (BSCC) is a poorly defined and often misunderstood cutaneous malignancy. OBJECTIVE: The purpose of this study was to compare, using immunohistochemical techniques, the BSCC, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). METHODS: BSCC occurring at Pennsylvania State University over the past 10 years were identified. Choosing seven BCC, and nine SCC as controls, all specimens were stained for keratin, lack of apoptosis, glycoproteins, and altered gene products using the avidin/biotin and strep-avidin immunoperoxidase techniques. Each malignancy was then graded for the percentage of cells stained with each marker. RESULTS: Of the markers studied, all stained to varying degrees the malignant aspects of the specimens. There were similar patterns between tumors, with the BSCC showing a transition zone between typical BCC and SCC. This was most striking for Ber-EP4, where over two-thirds of the BCC stained, none of the SCC, and half of the BSCC showed reactivity. CONCLUSION: BSCC has staining patterns similar to both the BCC and SCC. The presence of a transition zone does not support the concept that all BSCC are collision tumors, but rather a differentiation of one tumor into another. We confirm earlier reports that Ber-EP4 could be used to distinguish between classic BCC and SCC. AE1/AE3, bcl-2, TGF-alpha, and p53 were not helpful in separating the tumors.

Basal Cell Carcinoma↗
PubMed1997

Erythema ab igne caused by a car heater.

Erythema ab igne is a reticulated erythematous hyperpigmented eruption that occurs after chronic exposure to heat. In the past, the shins were the most common area of involvement, but with the widespread availability of central climate control in most buildings the incidence has decreased dramatically. New causes of erythema ab igne have been noted that have been caused by such heat sources as therapeutic chairs with built-in heaters. We present a case in which prolonged and close contact of the legs to a car heater led to erythema ab igne. Practitioners must be aware of the changing causes of erythema ab igne so that an appropriate history can be obtained.

Adult↗
PubMed1997

Systemic sarcoidosis presenting in the black dye of a tattoo.

Sarcoidosis is an idiopathic granulomatous disease with many cutaneous manifestations and a known predilection for scars and areas of previous trauma. We report the first case of systemic sarcoidosis presenting in only the black dye of a tattoo. The skin manifestations of sarcoidosis and the histologic differential diagnosis of granulomas are reviewed.

Adult↗
PubMed1997

Bilateral plantar amyloidosis: a unique presentation of localized cutaneous amyloidosis.

Nodular amyloidosis is uncommon and is due to a local production of amyloid by aberrant plasma cells. Localized bosselated plantar amyloidosis has been reported before but we present the first case to our knowledge of bilateral plantar amyloidosis. The clinical presentation as well as therapeutic options for this uncommon entity are reviewed.

Amyloidosis↗
PubMed1997

Congenital fascial dystrophy: the stiff skin syndrome.

Congenital fascial dystrophy is an uncommon disorder that may mimic scleroderma. The skin is bound down and feels "wood hard" on palpation of the trunk and extremities. Sclerodactyly, telangiectases, and nail fold changes are not present. Unlike scleroderma, the onset is at birth. Flexion contractures result and other associated abnormalities may include developmental delay and mild hirsutism. We report a typical case to illustrate the clinical and pathologic findings of patients with this disorder.

Adult↗
PubMed1997

Granular cell dermatofibroma. A benign tumor that can simulate malignancy.

We report on an unusual dermatofibroma with granular cells. The dermatofibroma contained mitotic figures raising a differential diagnosis that included malignant granular cell tumor. Granular cell dermatofibroma is an uncommon variant, but one that clinicians and surgeons should become aware of to ensure accurate diagnosis.

Adult↗
PubMed1996

Interstitial granulomatous dermatitis with arthritis.

BACKGROUND: Interstitial granulomatous dermatitis with arthritis is an uncommon systemic disorder involving the cutaneous and musculoskeletal systems. The eruption may mimic other dermatoses including granuloma annulare, erythema chronicum migrans, and the inflammatory stage of morphea. Key histopathologic characteristics, along with clinical correlation, allow accurate diagnosis. OBJECTIVE: We describe the clinical, serologic, and histologic features in three patients with interstitial granulomatous dermatitis with arthritis. METHODS: Skin biopsy specimens were examined and correlated with the clinical and laboratory findings. RESULTS: Erythematous, annular, indurated plaques on the extremities were present in two women. An erythematous, papular eruption on the head and neck was present in a third patient. All patients had myalgia and migratory polyarthralgias of the extremities along with various serologic abnormalities. Histologic examination revealed a dense lymphohistiocytic interstitial infiltrate involving primarily the reticular dermis. Foci of necrobiotic collagen were present. Vasculitis was absent. CONCLUSION: Interstitial granulomatous dermatitis with arthritis is unique multisystem disease with variable cutaneous expression. Abnormal serologic findings indicate a possible connection to collagen vascular disease.

Adult↗
PubMed1996

Radiation keratosis associated with exposure to a gold ring.

A radiation keratosis occurred in a woman who wore a radioactive gold ring forty-three years ago. Clinicians should be aware that not all "warty lesions" on the hands are actinic keratosis, seborrheic keratosis, or warts. Radioactive gold rings still exist. Diagnosis requires a high index of suspicion, since patients may no longer be wearing the offending ring.

Aged↗
PubMed1995

Decreased expression of the human progenitor cell antigen (CD34) in morphea.

Morphea is an idiopathic disorder the hallmark of which is fibrosis of the skin. The regulatory factors resulting in the increased collagen production have not been determined. Within the dermis there are dendritic cells with possible immunological functions that express either the human progenitor cell antigen (CD34) or factor XIIIa. Immunohistochemical stains for factor XIIIa, CD34, S100, proliferating nuclear cell antigen, and vimentin were performed on 26 skin biopsies from patients with morphea and 11 biopsies from normal skin. A decreased number of CD34-expressing cells was seen in the affected skin from morphea patients, while there was an increased number of cells expressing factor XIIIa and vimentin. We hypothesize that CD34-positive dendritic cells may have a regulatory role in collagen synthesis and that lack of CD34 expression can be used as a marker for morphea.

Adult↗
PubMed1995

Generalized non-Langerhans cell histiocytosis: four cases illustrate a spectrum of disease.

BACKGROUND: The proliferation of non-Langerhans cell histiocytes is a poorly understood process of unknown cause. Variation in the clinical features and/or histopathology of histiocytic proliferation has led to subclassification of the general category of non-Langerhans cell histiocytes. Although the current classification may provide some useful generalizations in regard to the anticipated clinical course, wide variability in presentation and outcome make this classification less than optimal when dealing with individual patients. The objectives of the study were to present four cases of generalized non-Langerhans cell histiocytosis. MATERIALS AND METHODS: Medical records and slides of four patients diagnosed with non-Langerhans cell histiocytosis at the Cleveland Clinic are reviewed. RESULTS: The patients exhibit features of more than one subtype of non-Langerhans cell histiocytosis. CONCLUSION: The overlap among the clinical and histologic features of the generalized cutaneous non-Langerhans cell histiocytic disorders suggests that they represent one disease entity with a wide spectrum of presentations rather than many distinct disorders.

Adolescent↗
PubMed1995

Cell surface molecules in basal cell carcinomas.

BACKGROUND: The factors determining a basal cell carcinoma's (BCC's) growth pattern and invasive potential are not known. In other tumors it has been shown recently that the expression of cellular adhesion molecules may determine a tumor's invasive and metastatic potential. Integrins, cell surface molecules important in cell stroma interactions, are present on BCCs and may help regulate the tumor's growth pattern. OBJECTIVE: We compared the expression of cellular adhesion molecules alpha 2 integrin, beta 1 integrin, intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), leukocyte function antigen 1a (LFA-1a), and E-selectin in different histological subtypes of basal cell carcinomas. METHODS: BCCs were obtained from patients undergoing Mohs surgery. The BCCs were classified as nodular, micronodular, mixed, infiltrative, and basosquamous types and stained using an avidin-biotin-immunoperoxidase technique with antibodies against alpha 2 integrin, beta 1 integrin, ICAM, LFA-1a, VCAM-1, and E-selectin. RESULTS: BCCs expressed alpha 2 and beta 1 integrin, but no significant differences in the amount or pattern of expression was seen in the different histologic subtypes. CONCLUSION: The expression of integrins by BCCs by binding to the surrounding stroma may limit BCC's growth; however, their expression does not appear to correlate with their histological pattern.

Adult↗
PubMed1995

Diagnosis of dermatitis herpetiformis by an avidin-biotin-peroxidase method.

BACKGROUND AND DESIGN: Immunofluorescence detection of stippled IgA in dermal papillae has been considered the gold standard in the diagnosis of dermatitis herpetiformis (DH). We have developed an immunohistochemical technique using the avidin-biotin-peroxidase complex that is equally effective as direct immunofluorescence in detecting IgA. We retrospectively studied 43 paraffin-embedded biopsy specimens obtained from patients with DH and a variety of other diseases for the presence of IgA along the basement membrane zone. RESULTS: Eleven immunofluorescence-proved cases of DH were found positive for IgA with the avidin-biotin-peroxidase method. One biopsy specimen originally classified as DH was identified and reclassified as linear IgA bullous disease based on the immunoperoxidase findings. All the samples that were positive on direct immunofluorescence were positive with the avidin-biotin-peroxidase method. Control samples of bullous pemphigoid, discoid lupus erythematosus, pemphigus vulgaris, and dermatitis were all negative for IgA deposition. CONCLUSION: The diagnosis of DH on formalin-fixed tissue is possible with the use of an avidin-biotin-peroxidase method, which is convenient and cost-effective.

Avidin↗