Biomedical subjects
Publications and source records attributed to K Weismann.
We report crusted (Norwegian) scabies in two patients with AIDS. Undiagnosed crusted scabies gives rise to outbreak of scabies in persons in close contact with the patients and in personnel and patients at the institutions. The described cases emphasize the importance of being aware of crusted scabies in patients suffering from AIDS.
Explore the source record for details and available documents.
Topically applied corticosteroid is a known provoking factor in perioral dermatitis. In recent years inhaled corticosteroids have become first line therapy for asthma in children. We present two characteristic cases of perioral dermatitis that developed during asthma treatment with budesonide using either a nebulizer or a spacer connected with a mask. In severe cases treatment with oral erythromycin or topical metronidazole gel may be considered. The eruption should not be confused with atopic eczema.
OBJECTIVE: To investigate, by use of the Amplicor PCR in a routine setting, the recovery rate of Chlamydia trachomatis in ano-rectal and pharyngeal swab samples obtained from males and females attending an STD clinic in relation to sexual practices, symptoms, and signs. DESIGN: Data regarding sexual practices, and symptoms and signs related to the rectum and pharynx, were obtained from 196 females and 208 males, including 31 homosexuals and eight bisexuals. Swab samples were obtained from the urethra, rectum, and pharynx from all the patients. An additional endocervical swab sample was obtained from the females. METHODS: All samples were analysed by the Amplicor PCR (Roche). SETTING: Rudolph Bergh's Hospital, a clinic for sexually transmitted diseases situated in the centre of Copenhagen, Denmark. RESULTS: The overall prevalence of urogenital C trachomatis infection was 9.2% (37/404). The specificity of the Amplicor PCR was 100% for both ano-rectal and pharyngeal swab samples. In females three (13%) of the 23 infections were detected only by testing an ano-rectal or throat swab sample. In homosexual males two (67%) of three infections were detected only by the anorectal swab sample. Ano-rectal intercourse without use of condom was reported by 44% of females and by 52% of homosexual males. Fellatio without condom use was reported by 91% of females, and 80% of heterosexual males practised cunnilingus. Pharyngeal infection, however, occurred only in females, and the presence of pharyngeal symptoms or signs seemed predictive for pharyngeal C trachomatis infection, for which the time of incubation or colonisation exceeded 3 months. The presence of ano-rectal signs or symptoms was not predictive for an ano-rectal C trachomatis infection. CONCLUSION: The Amplicor PCR can be used on ano-rectal and pharyngeal swab samples. Ano-rectal swab samples should be obtained in females and homosexual males at high risk of being infected. Pharyngeal samples should be taken in females at high risk of being infected, especially when pharyngeal signs or symptoms are present.
A 35-year-old Caucasian woman had bilateral indolent swelling of the temporal regions. Imaging studies with nuclear magnetic resonance, ultrasonography and histopathological investigation revealed enlargement of the temporal and masseter muscles, with no pathology in the skin or subcutaneous tissue. A small prolactinoma of the pituitary gland was incidentally found. The condition, designated benign masticatory muscle hypertrophy, should be distinguished from similar diseases affecting the skin and the subcutaneous tissue of the scalp. The cause remains unknown.
A male patient with green hair is described. The cause was exogenous deposition of copper from domestic tap water which contained an increased copper concentration. The discolouration disappeared promptly following the use of a penicillamine containing shampoo.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Dermatoscopy is a non-invasive investigative technique which makes it possible to evaluate the pigmented structures of the epidermis, the dermo-epidermal junction and the papillary dermal layer. The melanin pigmentation of the epidermal basal cell layers, the so-called pigment network is the primary target of dermatoscopy. A number of diagnostic criteria and variables for the dermatoscopy of pigmented skin lesions have been developed. Cutaneous malignant melanoma is still increasing in incidence and mortality. An early diagnosis is decisive for the prognosis. Therefore, it is urgent to develop practical investigative methods which can increase the diagnostic sensitivity. Dermatoscopy is such a method, but it demands training and experience. Lack of suspicious findings by dermatoscopy does not exclude malignancy. A safe diagnosis can only be obtained by a histological examination.
BACKGROUND: A study on HIV/AIDS-related mucocutaneous manifestations has been carried out in three different ethnic and geographic areas, namely Brazil, Denmark, and Thailand. METHODS: The Brazil cohort comprised 110 patients, the Danish cohort 150, and the Thai cohort 206 patients. The majority of the Brazil and Thai cohort patients belonged to groups III and IV according to the CDC clinical staging system, whereas the patients in Denmark called their doctors earlier and only 8% were classified in groups III and IV. RESULTS: In all three areas the number of mucocutaneous diseases correlated well with the progression of the HIV disease. Ethnic differences were not identified, whereas geographic differences related to skin infections were marked. In the Asian cohort a generalized fungal infection was detected with characteristic mucocutaneous symptoms caused by Penicillium marneffei. CONCLUSIONS: Teaching efforts about mucocutaneous signs as markers of HIV infection may be of value, particularly in developing areas, to allow earlier diagnosis. In future guidelines for classification of HIV/AIDS-related mucocutaneous diseases geographic considerations should be included.
Explore the source record for details and available documents.
INTRODUCTION: Topical application of podophyllin is a routine procedure in patients with ano-genital warts. Podophyllin is a crude plant extract and is therefore not a well-defined product. It may contain variable amounts of the active lignan podophyllotoxin and the majority of the dry weight of podophyllin is made up of substances never identified. OBJECTIVE: The purpose of the study was to estimate in podophyllin 20% the amounts of two mutagenic substances, quercetin and kaempherol. METHODS: Using high-pressure liquid chromatography the amounts of quercetin and kaempherol were determined in 3 batches of podophyllin 20%. RESULTS: Quercetin and kaempherol constitutes 2.5-3.8% and 6.0-6.4% of podophyllin dry substance, respectively. Podophyllotoxin constitutes in comparison 12.7-13.8% of podophyllin dry substance. CONCLUSION: As approximately 10% of the amount of dry substance in podophyllin 20% is composed of two mutagenic flavonoids, quercetin and kaempherol, efforts should be focused on the production of a well-defined purified podophyllotoxin preparation that may replace podophyllin for clinic use in patients with genital warts. Self-medication with purified podophyllotoxin 0.5% may be considered as first-line treatment in well-instructed patients with external genital warts.
Local complications of repeated injections of pentazocine are known among drug abusers. We hereby describe similar reactions in three patients who for several years had abused the opioid analgetic ketobemidone for chronic pain after abdominal surgery, and in six drug addicts who regularly injected ketobemidone tablets dissolved in water. In all nine patients an impressive clinical picture with disfiguring woody fibrosis and multiple irregular ulcers and scars surrounded by hyperpigmentation on the upper and lower extremities was seen. The skin lesions had been mistaken for aggressive forms of panniculitis, pyoderma gangrenosum or selfmutilation. Following direct questioning most patients admitted self-administration of the drug to the affected areas. The patients showed an apparent indifference about their extensive disabling skin disease, and no obvious complaints of pain, contrary to what might be expected from the pronounced tissue destruction and inflammation at the injection sites.
Explore the source record for details and available documents.
The incidence of syphilis in Denmark has changed within the last ten years. From being a relatively common disease at the end of the 1970's and beginning of the 1980's, the incidence has fallen considerably. It is assumed that the change is connected with the emergence of AIDS and the resulting increase in information and attention to sexually transmitted diseases. In the USA, after a fall in the beginning of the 1980's, the incidence of syphilis has risen markedly, particularly among heterosexual coloured people in large cities. Recently, there have been some reports claiming atypical syphilis in patients with HIV-infection. To date there are no controlled investigations to corroborate this notion. Seronegative syphilis or delayed seropositivity has been reported in certain immunosuppressed AIDS patients. Otherwise the syphilis serology of HIV-infected patients does not seem to differ essentially from HIV-negative patients. All patients with HIV infection should be counselled about syphilis and offered a test for syphilis, just as patients with syphilis should be encouraged to be tested for HIV antibody after informed consent.
In recent years, there have been sporadic reports of aberrant manifestations of syphilis and a changed syphilis serology in AIDS patients, which might indicate difficulties in diagnosing the infection and monitoring the response to penicillin treatment. Six male patients aged 25 to 42 years with asymptomatic HIV infection and secondary syphilis were retrospectively compared with a control group of seven HIV-negative males aged 26 to 52 years with secondary syphilis. All patients presented with macular-papular exanthema of secondary syphilis; in all cases it was also their first episode of the disease. The median WR titre was 13 (range 11 to 20) in syphilis patients with HIV and nine (8 to 14) in the control group (p = 0.1). The median time until WR was found non-reactive after penicillin was four months (3 to 16) and five months (3 to 9), respectively (p = 0.8). Thus, in this small series there was no statistically significant difference in the WR-titres of asymptomatic HIV positive and HIV negative patients with secondary syphilis, although there was a tendency towards initially higher WR titre in the HIV group, as reported by others.
Explore the source record for details and available documents.