Endemic "lime" disease: phytophotodermatitis in San Diego County.
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Biomedical subjects
Publications and source records attributed to L F Eichenfield.
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Nutritional deficiencies may be associated with a variety of cutaneous findings in children. This review emphasizes new developments relating to cutaneous findings of nutritional deficiencies. Zinc deficiency, acrodermatitis enteropathica, and acrodermatitis enteropathica-like eruptions are seen with a variety of conditions including cystic fibrosis, anorexia nervosa, and breastfeeding. Similar cutaneous findings not related to zinc deficiency may also occur with such metabolic disorders as methylmalonic aciduria, multiple carboxylase deficiency, essential fatty acid deficiency and other amino acid deficiencies. Vitamin K deficiency is associated with hemorrhagic disease of the newborn and coagulopathy. Vitamin A deficiency presents with a variety of systemic findings and distinctive dermatologic findings. Acute vitamin A deficiency may be seen in children infected with measles and is associated with more severe disease. The systemic and cutaneous findings of vitamin C deficiency, scurvy, are discussed.
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Many conditions present in childhood with vesicles and bullae, ranging from benign conditions to life-threatening diseases. This article reviews selected blistering disorders, with emphasis on new information that is helpful to the practicing physician. Entities that are discussed in this article include childhood zoster and fetal varicella syndrome, urticaria pigmentosa, scabies, bullous bug bites, lichen sclerosus et atrophicus, epidermolysis bullosa, and erythema multiforme.
Acne is a skin disorder of the sebaceous follicles that commonly occurs in adolescence and young adulthood. The pathogenesis involves abnormal follicular hyperkeratosis and obstruction of the follicle, stimulation of sebaceous gland secretion by androgens, and proliferation of Propionibacterium acnes, which promotes inflammation. Treatment regimens should be designed based upon an understanding of the multifactorial basis of pathogenesis. Both topical and systemic agents may be employed to normalize keratinization, decrease sebaceous gland activity, decrease the follicular P. acnes population, and minimize inflammation.
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We report 10 cases of neonatal erosions or ulcerations in giant congenital melanocytic nevi. Histopathologic examination, performed in eight cases, demonstrated benign findings. Clinical follow-up for an average of 3.8 years (range 2 weeks to 8 years) has not revealed the development of cutaneous melanoma. We conclude that erosions or ulcerations in giant melanocytic nevi in neonates are often benign and do not necessarily signify the presence of cutaneous melanoma.
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We report a 16-year-old Hispanic girl with gastrointestinal complaints and an unusual cutaneous eruption consisting of vesiculopustules and blanching erythematous plaques with peripheral scale. Diagnostic workup showed collections of neutrophils in the upper epidermis and subcorneal layer on the skin biopsy specimen, and deep ulcerations, crypt abscesses, and granulomas on endoscopy, diagnostic of Crohn disease. The skin findings are consistent with a vesiculopustular eruption without vasculitis, previously only reported in association with ulcerative colitis. This case broadens the spectrum of neutrophil-based cutaneous disorders associated with inflammatory bowel disease. Clinicians should be aware of the usual cutaneous manifestations of inflammatory bowel disease and consider the diagnosis of Crohn disease in the context of vesiculopustular dermatitis and abdominal symptomatology.
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