Generalized granuloma annulare in a patient with acquired immunodeficiency syndrome (AIDS)
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Biomedical subjects
Publications and source records attributed to L Bakos.
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The sign of Leser-Trélat in a patient with squamous cell carcinoma of the cervix is reported. This seems to be the first report of this association. Literature was reviewed, try to correlate this entity with acanthosis nigricans and to link this sign with internal malignancy or other kind of epidermal stimuli.
The term "metastatic" Crohn's disease is used to define the cutaneous lesions, distant from the gastrointestinal tract and separated from other ulcerations by normal skin, showing granulomatous histology. A case of Crohn's disease with metastatic ulcerations of the vulva, perineum, submammary folds, groins and abdominal fold is presented. In the literature only 26 similar cases were found. Cutaneous manifestations associated to Crohn's disease, its classification and treatment are commented. The excellent response of our case to metronidazole is stressed.
The episodic fluctuation of serum testosterone, androstenedione, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHAS) and cortisol levels was analysed to determine the reliability of a single blood estimate in characterizing the mean value of a 4 h period. Radioimmunoassay of the steroids was performed in sera of 8 apparently healthy women in various phases of the menstrual cycle in 10 min intervals between 08 and 12 h a.m. Reliability criteria of the methods used were comparable to those in common use. The within-person fluctuation of individual values was determined by the coefficient of variation of single estimates, and the methodological error of the single estimates was characterized with the maximum increment from the mean at 95% confidential limits. A maximum deviation of 30.8, 28.6, 37.0, 25.0 and 61.2%, respectively, found in the above order of steroids, suggests several hormone estimations to be necessary for judging hormone availability in a subject.
The episode fluctuation of serum LH, FSH and prolactin levels in peripheral blood was studied to determine the reliability of single estimates of the average blood level. Radioimmunoassay of the hormones was performed in serum withdrawn every 10 min between 8 and 12 h a.m. from 8 healthy women in various periods of the menstrual cycle. The rate of fluctuation of the hormone levels was characterized by the within-person coefficient of variation of single estimates, which averaged 30.3, 15.1 and 19.2% for LH, FSH and prolactin, respectively. Due to a pronounced fluctuation of gonadotropin levels, analysis of several serum samples is recommended to approach the actual mean hormone level.
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Some classifications of Leprosy currently in use are reviewed and the difficulties of their application in field work are analysed. While it is recognized the scientific value of these classifications in order to identify precisely the clinical, bacteriological, histological and immunological aspects of the disease, an alternative simplified classification is suggested, to be used in control programmes. In this classification clinical forms that require the same public health action are put together. Thus, clinical forms are reduced to three basic groups. The clinical and laboratory criteria which define each group are presented, as well as the correlation between this simplified classification and the classic one.
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On the basis of (a) our epidemiological studies of ankylosing spondylitis (AS) (males 0.4 per cent, females 0.08 per cent), (b) typing of 352 normal persons (frequency of HLA B27 = 12.78 per cent), and (c) typing of 55 AS patients (frequency of HLA B27 = 92.73 per cent), we have calculated the prevalence of AS for the total Hungarian population over 15 years of age. Among males with the B27 anitgen, AS occurs in 2.9 per cent, and in B27 positive females 0.58 per cent. In the population without the B27 antigen, the prevalence of the disease is 0.03 per cent and 0.006 per cent respectively. The quotients of these data show that a person with the B27 antigen has approximately 87 times greater risk of developing AS, than does a person of the same sex without this antigen.
Three cases of the so-called "histoid variety" of lepromatous leprosy are reported. This variety has definite clinical features, associated with characteristic histological and bacteriological findings. Some of the features presented by our patients are similar to those described originally by Wade, especially the resistance to treatment. Considering the discrepancies existing among the authors which studied the subject, our opinion is that further studies should be done in order to elucidate the controversial points,
Three cases of the so-called "histoid variety" of lepromatous leprosy are reported. This variety has definite clinical features, associated with characteristic histological and bacteriological findings. Some of the features presented by our patients are similar to those described originally by Wade, especially the resistance to treatment. Considering the discrepancies existing among the authors that studied the subject, our opinion is that further studies should be done in order to elucidate the controverted points.
Two cases of Porphyria cutanea tarda with sclerodermoid changes associated with cataracta are studied. Far from being considered as an authentic scleroderma, the sclerodermoid aspect, very common in patients with Porphyria cutanea tarda, seems to represent one among the many residual alterations of the precocious cutaneous senescence, peculiar to these individuals hypersensitive to luminic radiations. The first patient had familial cases of cataracta. The second had no familial occurrence of it. The association of cataracta and Porphyria cutanea tarda, for the first time mentioned in the literature, would be one complication to be added to this very polymorphous syndrome.
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