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Biomedical subjects

O F Miller

Publications and source records attributed to O F Miller.

36 records · Page 2Linked to original sources

Essentials of pressure ulcer treatment. The diabetic experience.

BACKGROUND: Diabetes accounts for over half of the lower extremity amputations in the United States. However, ulcers of the diabetic foot can often be treated successfully and amputations avoided. OBJECTIVE: To review treatment of diabetic foot ulcers. RESULTS: Physicians must recognize the critical clinical and diagnostic features of ischemic and neuropathic ulcers. Therapy is directed towards vascular repair in the ischemic ulcer and relief of weight bearing through casting and shoes with molded insoles in the neuropathic ulcer. Sound principles of wound care apply to all ulcers. CONCLUSION: For successful preventive foot care patients and physicians need to understand how and why ulcers form and the rationale for the types of footwear and care necessary to prevent ulcers.

Diabetes Complications↗

Gypsy moth caterpillar dermatitis--revisited.

Gypsy moth caterpillar dermatitis is a pruritic, papular, urticarial eruption on exposed skin that occurs most commonly after direct contact with the first instar larva of the gypsy moth (Lymantria dispar). We present two case reports to illustrate its clinical and histopathologic features. Both cases occurred during the spring of 1990 and coincided with the greatest infestation of L. dispar in the Northeast to date. The pathogenesis of this distinctive gypsy moth dermatitis most likely involves histamine release by the caterpillar and a delayed hypersensitivity reaction in its host.

Animals↗

Tinea pedis in prepubertal children: does it occur?

Fifteen children who had foot dermatitis were evaluated by examinations with potassium hydroxide and fungal cultures. In eight cases dermatophyte infection was identified. Tinea pedis in prepubertal children is more common than previously reported.

Adolescent↗

Atrophia maculosa varioliformis cutis.

We describe a case of atrophia maculosa varioliformis cutis (AMVC), a rare form of idiopathic facial macular atrophy. A biopsy revealed only a depression in the epidermis, probably caused by loss of dermal collagen. Because AMVC may be confused with scarring, and factitial disease may be suggested, it is important that this condition be recognized by the physician.

Adult↗

Cutaneous bronchogenic cyst with papilloma and sinus presentation.

The thirty-eighth case of bronchogenic cyst in the skin is reported in a 5-year-old boy. This is the first case report of cutaneous bronchogenic cyst presenting as a distinct, pedunculated growth with a sinus tract at the base. Embryogenesis, differential diagnosis, and treatment are discussed.

Branchioma↗

Epidermodysplasia verruciformis: response to therapy with dialyzable leukocyte extract (transfer factor) derived from household contacts.

Dialyzable leukocyte extracts (DLE) have been used to treat a variety of antigen selective, and broad spectrum immunodeficiency diseases with sometimes encouraging results. We describe here the clinical and laboratory responses to DLE therapy of 2 patients with epidermodysplasia verruciformis (EV), a chronic cutaneous infection with a variety of human papilloma viruses. One patient with longstanding (30 yr) disease and no improvement to previous therapy showed gradual yet definite resolution of extensive verrucae planae, plaque, tinea-versicolor-like, and tumor lesions scattered over his entire integument. Cessation of DLE therapy for a short time resulted in recurrence of partially regressed lesions and also in the development of new tumors in this patient. The second patient, a grandson of the first patient, with minimal disease showed no progression of the disease during DLE prophylaxis. A third subject (brother of patient number 2) received no DLE and served as a control. All 3 subjects demonstrated severely depressed levels of suppressor T cells, a defect in cell-mediated immunity that has not been hitherto reported in patients with EV. Finally, evidence is presented for a possible X-linked recessive mode of inheritance for susceptibility to EV.

Adult↗

Cryo-curettage of cherry angiomas.

Cherry angiomas pose a cosmetic problem in some patients. The most commonly recommended treatment modalities in the past have been electrodesiccation and cryotherapy with liquid nitrogen. This report describes a simple and quick technique for removal of cherry angiomas with excellent cosmetic results using a topical anesthetic refrigerant spray and a sharp curet. Patients experience minimal discomfort.

Cryosurgery↗

Acne keloidalis nuchae: report and treatment of a severe case.

Acne keloidalis nuchae (folliculitis keloidalis or dermatitis papillaris capillitii) is a chronic, deep, scarring folliculitis of the nuchal area. Therapeutic measures such as oral and topical antibiotics, intralesional injections of fluorinated adrenocorticosteroids, and radiotherapy are sometimes effective in controlling this condition. A case of refractory acne keloidalis is presented to show the curative possibility of aggressive surgical therapy.

Acne Keloid↗

Lichen spinulosus: response to therapy.

Two cases of lichen spinulosus and the response to therapy with Keralyt under occlusion are presented. It is evident that Keralyt under occlusion for two consecutive weeks will clear these lesions. However, twice weekly application of Keralyt must be used in order to keep these areas free of lesions. An undesirable side effect in the two patients presented was a burning, stinging sensation immediately following application of Keralyt.

Adult↗

Midline cutaneous and spinal defects. Midline cutaneous abnormalities associated with occult spinal disorders.

Failure of separation of the neuroectoderm from the epithellal ectoderm to proceed in an orderly and complete fashion results in a wide variety of defects involving the skin, spinal cord, and cauda equina, as well as the surrounding structures of mesodermal origin. Congenital dermal sinuses occur most commonly in the lumbosacral region, are usually associated with a spina bifida, and may connect the skin directly to the spinal canal. Epidermoid or dermoid cysts may form at any point along a dermal sinus. Four types of cutaneous or subcutaneous abnormalities commonly seen associated with occult spinal disorders are abnormal hair, angioma, lipoma, and dimple. It is essential that these lesions are investigated at an early age, since surgical excision may prevent future neurologic deficits.

Adolescent↗

The musculoskeletal manifestations of acne fulminans.

We describe a relatively uncommon and poorly understood relationship between a particularly severe form of acne and an associated arthritis. Two young men are described, 1 of whom possesses the HLA-B27 antigen. Their clinical courses are described, responses to therapeutic intervention outlined, and some speculation regarding etiology is made. A review of the literature is included. The prognosis is uncertain, since 1 of the patients has sacroiliitis.

Acne Vulgaris↗