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Biomedical subjects

L E Gibson

Publications and source records attributed to L E Gibson.

At least 91 records · Page 5Linked to original sources
PubMed1988

Necrobiosis lipoidica diabeticorum with cholesterol clefts in the differential diagnosis of necrobiotic xanthogranuloma.

The histopathologic findings in 331 cases of necrobiosis lipoidica diabeticorum seen during a 50-year period were reviewed. Three cases showing cholesterol cleft formation were found. All 3 cases were associated with severe diabetes mellitus. The differential diagnosis of importance is necrobiotic xanthogranuloma. Common features included extensive hyaline necrobiosis and foreign-body giant cells. Atypical and Touton-type giant cells are more common in necrobiotic xanthogranuloma. Vascular changes in necrobiotic xanthogranuloma may include granulomatous involvement of muscular walls with thrombosis. Explanations for cholesterol cleft formation are offered. When cholesterol clefts are seen in biopsy specimens of necrobiosis, necrobiotic xanthogranuloma must be ruled out. In addition, when found in necrobiosis lipoidica diabeticorum, these clefts may imply diabetes mellitus with complications.

Adult↗
PubMed1987

Dermatologic disorders in patients with thymoma.

We describe the cutaneous disorders in 172 patients with thymoma. Myasthenia gravis was the most common additional disease. Cutaneous disorders were found in 34 patients; 19 had skin disorders at the time of diagnosis of thymoma and 15 developed skin disorders after diagnosis of thymoma. Cutaneous fungal diseases were found in fewer than 10% of the patients (tinea pedis excluded). One patient with chronic mucocutaneous candidiasis was included in this group. Two patients with lichen planus, 2 with pemphigus, 2 with myositis, and 1 with lupus-like disease were also included in this study. Patients with skin disorders were no different than patients without these disorders with regard to thymoma histology, age at diagnosis, sex, or presence of myasthenia gravis. There were no associations between these variables and the patients who developed these skin disorders after diagnosis of thymoma. Thymectomy did not alter the clinical course with respect to cutaneous diseases.

Adult↗
PubMed1986

Cutaneous granulomatous vasculitis: its relationship to systemic disease.

Microscopic and medical review of twenty-six patients with skin biopsy specimens that showed granulomatous vasculitis demonstrated vascular histiocytic granulomas with fibrinoid destruction of blood vessels in the dermis and panniculus. Cultures of the biopsy specimens were nonspecific. The skin lesions varied from erythema to papulonodular and vesicular eruptions; they were usually on the extremities but also involved the trunk. Eight patients had systemic lymphoproliferative diseases: three, lymphoma; two, angioimmunoblastic lymphadenopathy; two, preleukemia; and one, chronic granulocytic leukemia. Five of these eight patients died within 2 years after the onset of skin lesions. The four patients with systemic vasculitis died within 1 year after the onset of skin lesions. Five patients with arthritis, four with gastrointestinal disease, three with systemic sarcoidosis or sarcoidlike disease, and one with tuberculosis had a more favorable prognosis. The histologic pattern of cutaneous nonlymphomatoid granulomatous vasculitis is associated with significant systemic disease, especially lymphoproliferative disorders. Patients with lymphoproliferative disorders or systemic vasculitis have a much poorer prognosis than those with inflammatory or infectious granulomatous disease.

Adult↗
PubMed1986

Henoch-Schönlein vasculitis: direct immunofluorescence study of uninvolved skin.

Henoch-Schönlein purpura is a multisystem disease believed to be a consequence of entrapment of circulating IgA-containing immune complexes in blood vessel walls throughout the skin, kidney, and gastrointestinal tract. In this direct immunofluorescence study, twenty-five skin biopsy specimens from twenty patients with Henoch-Schönlein purpura were examined (9 from uninvolved, normal-appearing skin). A distinct stippled pattern of vascular fluorescence was found in 87% of lesion biopsies; 75% of these contained deposits of IgA. In uninvolved skin, seven (78%) showed immunoglobulin in vessel walls and six (67%) contained IgA, suggesting that immune complexes are deposited with equal frequency in normal-appearing and lesional skin of patients with Henoch-Schönlein purpura. Biopsy of uninvolved, rather than of purpuric, skin for direct immunofluorescence studies may be more helpful in confirming the diagnosis of Henoch-Schönlein purpura because tissue morphology is usually of better quality.

Adolescent↗
PubMed1986

Direct immunofluorescence for the study of cutaneous drug eruptions.

Forty-one patients with drug eruptions were retrospectively evaluated to correlate clinical, direct immunofluorescence, and dermatopathologic findings. Forty-six biopsy specimens were obtained for immunofluorescence in addition to specimens for dermatopathologic study. Eighteen patients had blood vessel fluorescence. Fourteen patients had basement membrane zone fluorescence. Eleven patients had dermatopathologic evidence of lichenoid changes; 8 of these had basement membrane zone fluorescence. Triamterene-hydrochlorothiazide caused the most eruptions (six patients). Positive direct immunofluorescence findings may aid the diagnosis of drug eruptions, especially in the presence of a nonspecific clinical picture or histopathologic findings.

Basement Membrane↗
PubMed1985

Neutrophilic dermatoses and myeloproliferative disease: report of two cases.

The term "neutrophilic dermatosis" has been suggested for a spectrum of skin lesions that have been noted in some patients with myeloproliferative diseases. These cutaneous conditions vary from plaques typical of Sweet's syndrome to bullous and pyodermatous lesions. We describe two patients with neutrophilic dermatoses and myeloproliferative disorders. Distinctive features included concurrent bullous pyodermatous lesions and characteristic lesions of Sweet's syndrome in one patient and overwhelming sterile pulmonary infiltration in the other patient. These disorders may be difficult to distinguish from acute infectious processes, and they may have systemic components, including pneumonitis. Possible therapeutic alternatives to systemic corticosteroid therapy are suggested.

Aged↗
PubMed1985

Skin lesions from sun exposure: a treatment guide.

Leukoplakia is a clinical term that may histologically represent actinic changes or frank squamous cell carcinoma. Because the nature of dysplasia may differ in various portions of the involved lip, adequate histologic examination is mandatory. Histologic characteristics of squamous cell carcinoma include loss of cell organization and orientation, loss of intercellular bridges, presence of nuclear atypia and mitotic figures, and premature cell keratinization.

Acute Disease↗
PubMed1980

Cooperative study comparing three methods of performing sweat tests to diagnose cystic fibrosis.

Directors of cystic fibrosis centers in the United States have noted an increasing number of patients with histories of either false-positive or false-negative sweat tests. These inaccuracies were attributed to the use of rapid test methods which avoided actually weighing the sweat collected. These rapid tests have inherent difficulties which, theoretically at least, could lead to mistaken diagnoses. To evaluate methods of performing the sweat test, the National Cystic Fibrosis Foundation organized a combined study comparing the older Quantitative pilocarpine iontophoretic test (QPIT) method of performing the test with two newer and more rapid methods, the Orion skin electrode, and the Medtherm conductivity apparatus. Five cystic fibrosis centers participated in the study. Although two centers obtained considerably more accurate results with the Orion and the Medtherm than did the other three centers, the combined results of the study indicate that these procedures can be considered to be little more than screening tests.

Child↗
PubMed1979

Negative effects of oral fatty acid supplementation on sweat chloride in cystic fibrosis.

Essential fatty acid supplementation with oral safflower oil (1 gm/kg/day) to 11 cystic fibrosis patients (aged 6 months to 14 years) for one year produced no significant change in sweat chloride concentration (mEq/liter) or sweat rate (gm/min/m2), Addition of vitamin E (10 mg/kg/day) to the safflower oil had no effect on sweat chloride concentration or rate compared to placebo. No clinical improvement could be detected compared to a control group. These results do not support previous reports of the effects of fatty acid supplementation on sweat electrolyte concentrations in cystic fibrosis.

Adolescent↗