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Biomedical subjects

P R Carrington

Publications and source records attributed to P R Carrington.

18 recordsLinked to original sources
PubMed2000

Tacky but refined: a "slick" technique for dressings that hold better.

For decades benzoin has been used to enhance the "stickiness" of the skin for improved adherence complementing the protective and functional aspects of well-constructed surgical bandages/dressings. The fully adherent and longer-lasting pressure dressing is both aesthetically pleasing to the patient (and surgeon) and, at the same time, functions to decrease seroma or hematoma formation, enhances antisepsis by blocking transient bacterial contamination, and inhibits traumatic sabotage of surgical wounds due to patient overactivity or inadvertent collision with a door jam, car door, table leg, or grandchild, etc. Also, when the bandage looks good, the patient realizes the operation was a success (at least aesthetically). Although simple, our additional steps of deoiling the skin with acetone, followed by multiple compress/release cycles of gauze to the Mastisol area reaps benefits to the patient and surgeon both in function (adherence) and in the production of a truly "dressy" beautiful and long-lasting dressing. In this way, the dressing "bed" is not only more receptive to one's aesthetically pleasing bandage, but is more tacky, yet refined. This same technique can be utilized prior to application of adhesive strips to healing wounds after sutures have been removed, allowing them to "stay on" longer with potentially better cosmesis and less spreading of the scar.

Adhesiveness↗
PubMed1999

Basal cell carcinoma: a comparison of shave biopsy versus punch biopsy techniques in subtype diagnosis.

BACKGROUND: There are two standard ways to obtain tissue for histologic classification of a clinically suspected basal cell carcinoma: shave and punch biopsy. However, information on the value of each method is limited. OBJECTIVE: The purpose of this study was to identify accuracy rates of two standard biopsy techniques in diagnosing subtypes of basal cell carcinoma. METHODS: A total of 86 cases were identified that had received either a punch or a shave biopsy with subsequent total excision of tumor. The biopsy specimens and excisions were compared for histologic correlation. RESULTS: Analysis of specimens from punch and shave biopsies produced equivalent diagnostic accuracy rates: 80.7% and 75.9%, respectively. There was no statistically significant tendency to overcall or undercall any particular tumor subtype on the basis of the type of biopsy procedure used. CONCLUSION: For histologic classification of basal cell carcinoma, there is an approximately 80% accuracy rate with both the shave and the punch biopsy. Therefore either biopsy technique is appropriate.

Biopsy↗
PubMed1999

Spiders and Borrelia burgdorferi: no evidence of reservoir occurrence in central Arkansas.

BACKGROUND: Although Ixodes ticks are considered the chief vector for Borrelia burgdorferi in the USA, B. burgdorferi has also been identified in mosquitoes, horse flies, and deer flies. We examined the possibility of these organisms being harbored in two species of spider in central Arkansas. METHODS: Ten wolf spiders (Lycosa gulosa) and two brown recluse spiders (Loxosceles reclusa) were collected in central Arkansas during early summer and fixed in formalin. Paraffin-embedded sections of the spiders were examined for spirochetes using the modified Steiner spirochete staining method and examined for B. burgdorferi using immunohistochemistry. RESULTS: All 12 spiders from both species were found to be negative for all spirochetes including B. burgdorferi. CONCLUSIONS: Spiders in our sample appeared not to harbor B. burgdorferi. Further studies utilizing larger sample sizes, more sensitive testing measures, or spiders from an area more endemic with B. burgdorferi may further prove or disprove that spiders are capable of harboring this organism.

Animals↗
PubMed1998

Plaque-like erythema with milia: a noninfectious dermal mucinosis mimicking cryptococcal cellulitis in a renal transplant recipient.

Cellulitis of the skin is most commonly a bacterial infection caused by either staphylococcal or streptococcal species. However, in immunocompromised patients, cellulitis may be a harbinger of more ominous disease. In these patients, rapid clinical diagnosis and treatment is necessary. We describe an immunosuppressed renal transplant recipient with the clinical diagnosis of cryptococcal cellulitis who was found to have a heretofore unreported dermal mucinosis of the upper chest associated with milia. We believe that cyclosporine was a significant pathogenic factor. This entity, which should be included in the clinical differential diagnosis of cryptococcal cellulitis, has a benign nature and does not require treatment.

Aged↗
PubMed1998

Deep penetrating dermatofibroma.

BACKGROUND: Deep penetrating dermatofibroma is an unusual and histologically distinctive form of dermatofibroma that usually occurs on the lower extremities of adults. OBJECTIVE: The dermatologic surgeon and pathologist should be aware of this entity to prevent excessive treatment of a benign condition. METHODS: We are reporting a case of deep penetrating dermatofibroma with the results of histologic examination and immunohistochemical studies. RESULTS: The neoplasm consisted of a fibrohistiocytic tumor penetrating into the subcutis accompanied by scalloped extensions along the septae. Immunohistochemical stains were positive for Factor XIIIa and negative for CD34. CONCLUSION: Recognition of the histologic pattern is important in distinguishing deep penetrating dermatofibroma from dermatofibrosarcoma protuberans.

Dermatofibrosarcoma↗
PubMed1998

Grover's disease (transient acantholytic dermatosis): relationship of acantholysis to acrosyringia.

Transient acantholytic dermatosis is often associated with excessive sweating, fever, and bed confinement. The pathogenesis of this disease has been postulated to be poral occlusion of damaged eccrine intraepidermal ducts. Histological and immunohistochemical and ultrastructural studies were performed on 10 biopsies from 10 patients with transient acantholytic dermatosis. Immunoreactions for carcinoembryonic antigen and cytokeratin-7 to identify eccrine duct epithelium were performed on all 11 biopsies. In addition, 5 of the biopsies were immunoreacted for cytokeratin 8. All immunoreactions were reviewed independently by two observers to determine extent of reactivity and whether it correlated with areas of epidermal acantholysis. Among the 11 biopsies, 8 showed acantholysis not associated with eccrine duct outflow tracts. In 2 biopsies the acantholysis was consistently associated with acrosyringea; in one case acantholysis was inconsistently associated with eccrine outflow tracts. Epidermal acantholysis in patients with Grover's disease is associated with the outflow tracts of eccrine ducts in a subgroup of patients. Although leakage of sweat from occluded sweat ducts in acrosyringia may be the mechanism operating in a subgroup of patients with Grover's disease, this does not appear to be the subgroup of patients in whom Grover's disease develops in the setting of being bedridden and/or sweating.

Acantholysis↗
PubMed1996

Atrophoderma elastolytica discreta.

Atrophoderma elastolytica discreta is the clinicopathologic name for a unique entity herein first described in a patient with cutaneous lesions simulating atrophoderma of Pasini and Pierini but coupled with histopathologic changes of anetoderma. The clinical and histological findings seen here have not been previously seen in the many variants of anetoderma, and, as such, they are sui generis evidence of a new entity in clinical dermatology.

Abdomen↗
PubMed1995

Hypopigmented macules in acantholytic disorders.

BACKGROUND: Widespread hypopigmented macules are rarely seen in heavily pigmented patients with Darier's disease. Previous hypotheses concerning the cause of decreased pigmentation suggest it is a postinflammatory phenomenon or that the hypomelanosis is evidence of subclinical acantholysis. PATIENTS: This report presents 2 patients: a new case of disseminated guttate leukoderma in a black patient with Darier's disease and the first such case in a patient with transient acantholytic dermatosis (Grover's disease). Direct immunofluorescence and electron-microscopic studies were carried out on lesional biopsies. OBSERVATIONS: Numerous small hypopigmented macules were observed in two black patients followed for acantholytic disorders. Three biopsies of the hypopigmented macules revealed acantholysis, while one showed only decreased melanin. Direct immunofluorescence studies were negative. Electron-microscopic studies of the leukodermic macules showed sparse melanocytes and melanosomes that were mostly pigmented stage IV melanosomes. CONCLUSIONS: Disseminated guttate leukoderma can occur in transient acantholytic dermatosis, as well as in Darier's disease. It is readily apparent on darkly pigmented skin because of contrast. The etiology of this phenomenon is still unknown.

Acantholysis↗
PubMed1994

Trichorhinophalangeal syndrome, type I.

We describe a patient with trichorhinophalangeal syndrome type I (TRPS-I) who had been previously diagnosed as having anhidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome). The TRPS-I phenotype is characterized by fine, sparse, brittle hair in association with a bulbous pear-shaped nose, tented alae, a long extended philtrum, a thin upper lip, and a horizontal groove on the chin. There may be clinobrachydactyly with ulnar deviation and dystrophic nails. The radiographic findings include cone-shaped epiphyses of the middle phalanges with shortened metacarpals. Genetic findings include deletion of chromosome band 8q24.12. Patients with all variants of TRPS need prompt and accurate assessment because musculoskeletal dysplasia is a universal feature in this syndrome. We review TRPS and similar syndromes to assist the accurate diagnosis of these lifelong maladies.

Child↗
PubMed1993

Enalapril-associated erythema and vasculitis.

Our pharmacologic armamentarium is expanding at a tremendous pace, and requires that we as clinicians maintain a certain level of knowledge of the drugs that we use, as well as their metabolism, and how they may function, both positively and negatively, in a given patient. Certain drugs, such as the angiotensin-converting enzyme inhibitors, interfere with the natural deactivation of certain vasoactive substances normally present in the body. Since many of these systems are functionally interrelated (eg, angiotensin-converting enzyme and kininase II), we may see cutaneous side effects when these drugs are administered. Enalapril is an angiotensin-converting enzyme inhibitor that promoted a cutaneous eruption in a patient with renal failure secondary to diabetes. We suspect that our patient's vasculitis and maculopapular erythema is included in a large number of polymorphic eruptions that can be seen with angiotensin-converting enzyme inhibitors, and review the operative pathogenetic mechanism. Many of these side effects are dose related, and can be controlled or eliminated by lowering the dosage of angiotensin-converting enzyme inhibitor, depending upon the clinical circumstances.

Adult↗
PubMed1982

Cervical thymic cyst.

Various types of cysts that originate in embryonal remnants may be observed in the neck. Among these, branchial cleft and thyroglossal duct cysts are more commonly observed, whereas thymic cysts are rare. Most patients with a cervical thymic cyst complain of a painless, enlarging mass in the neck. The histopathologic features of thymic cysts are diagnostic. Cystic thymomas, which seem to have a more aggressive clinical behavior in children, should be differentiated from the benign cervical thymic cyst. Thymic cysts most probably arise from embryonic remnants of the thymopharyngeal duct. Our patient had a cervical thymic cyst with neurofibromatosis.

Child↗